NPIMap

Organization Active NPI

Oklahoma State Department of Health

  • Clinical Medical Laboratory
  • Stillwater, OK
National Provider Identifier
1477670529
Registry record updated Dec 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
OKLAHOMA STATE DEPARTMENT OF HEALTH
Practice address
4615 W Lakeview Rd
Stillwater, OK 74075-2173
Phone
(405) 564-7750
NPI assigned
Mar 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2025

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

Authorized official

Name
Jennifer Han, PH.D.
Title
Director
Phone
(405) 426-8139

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

4615 W Lakeview Rd
Stillwater, OK 74075-2173

Mailing address

123 Robert S Kerr Ave Ste 1702
Oklahoma City, OK 73102-6406
Phone (405) 426-8650

Other practice location 1

123 Robert S Kerr Ave Ste 1702
Oklahoma City, OK 73102-6406
Phone (405) 426-8650

Other identifiers 1

IdentifierTypeStateIssuer
100758760AMedicaidOK

National Provider Directory

National Provider Directory
Tax ID family
Sallisaw State Veterans Home140 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764892800000",
    "number": "1477670529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 ROBERT S KERR AVE STE 1702",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731026406",
            "telephone_number": "405-426-8650",
            "fax_number": "405-900-7598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4615 W LAKEVIEW RD",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740752173",
            "telephone_number": "405-564-7750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 Robert S Kerr Ave Ste 1702",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731026406",
            "country_code": "US",
            "telephone_number": "405-426-8650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OKLAHOMA STATE DEPARTMENT OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A",
        "authorized_official_last_name": "HAN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "405-426-8139",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100758760A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.