NPIMap

Organization Active NPI

Tulsa Medical Laboratory, LLC

  • Clinical Medical Laboratory
  • Tulsa, OK
National Provider Identifier
1457468464
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
37D1002749 Issued in OK
Legal business name
TULSA MEDICAL LABORATORY, LLC
Practice address
5110 S Yale Ave Ste 100
Tulsa, OK 74135-7438
Phone
(918) 712-5571
Fax
(918) 747-7831
NPI assigned
Aug 24, 2006
Last updated
Oct 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Heather Charles
Title
Business Manager
Phone
(918) 281-6808

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 37D1002749 OK
Clinical Medical Laboratory 291U00000X 37D1002749 OK Primary

Addresses

Primary practice location

5110 S Yale Ave Ste 100
Tulsa, OK 74135-7438

Mailing address

5700 Southwyck Blvd
Toledo, OH 43614-1509
Phone (800) 288-8325

Other identifiers 1

IdentifierTypeStateIssuer
100707130AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091203000254 OK Part B Supplier - Independent Clinical Laboratory 4486732799 Practice locations: Tulsa, OK

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D1002749Tulsa Medical Laboratory, LLC5110 S Yale Ave, Ste 100, Tulsa, OK 74135AccreditationJul 31, 2026

National Provider Directory

National Provider Directory

Locations

2738 E 51st St
Ste 290
Tulsa, OK 74105

6565 S Yale Ave
Ste 410
Tulsa, OK 74136
Phone (918) 712-5571

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761696000000",
    "number": "1457468464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 SOUTHWYCK BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436141509",
            "telephone_number": "800-288-8325",
            "fax_number": "419-866-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5110 S YALE AVE STE 100",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741357438",
            "telephone_number": "918-712-5571",
            "fax_number": "918-747-7831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TULSA MEDICAL LABORATORY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A",
        "authorized_official_last_name": "CHARLES",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "918-281-6808"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "OK",
            "license": "37D1002749",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "OK",
            "license": "37D1002749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100707130A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.