Prime Laboratories LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PRIME LABORATORIES LLC

Practice address

1130 N 9TH St
Broken Arrow, OK 74012-2388

Phone

(918) 940-3180

NPI assigned

Jun 10, 2015

Last updated

Apr 11, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ben Conley

Title

Ceo

Phone

(918) 940-3180

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1433894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460332800000",
    "number": "1508247073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 N 9TH ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740122388",
            "telephone_number": "918-940-3180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 N 9TH ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740122388",
            "telephone_number": "918-940-3180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME LABORATORIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-10",
        "last_updated": "2016-04-11",
        "status": "A",
        "authorized_official_last_name": "CONLEY",
        "authorized_official_first_name": "BEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "918-940-3180"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200622820",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ann Prewitt
• Julia P. Price, MSN/RN
• Landon D Price, M.D.
• Samuel Winston Price
• Taylon Price, RBT
• Prime Mobility Medical Equipment & Repair Inc
• Mykelti Lynn Pritchard
• Eva Lee Pritt
• Proactive Sport and Spine PLC
• Cole Andrew Proctor

• Clinical Medical Laboratory in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Clinical Medical Laboratory in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2016; 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.