STATELINE MEDICAL LLC
NPI 1114421260
Clinical Medical Laboratory in Pocola, OK

Active since March 22, 2018
105 N POCOLA BLVD, SUITE 2, POCOLA, OK 74902(479) 561-2448 Get Directions Write a Review

NPPES record last updated: March 22, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Stateline Medical Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STATELINE MEDICAL LLC (NPI 1114421260) is a healthcare organization registered as a clinical medical laboratory in Pocola, Oklahoma and active in the NPI registry since March 2018. The organization lists Shane Walker, Owner, as its authorized official.

NPPES Registry Identity

NPI1114421260
Entity TypeOrganization
Primary Taxonomy291U00000X
Legal Business NameSTATELINE MEDICAL LLC
Location Address105 N POCOLA BLVD, SUITE 2Pocola, OK 74902-3101
Mailing Address105 N Pocola Blvd, Suite 2Pocola, OK 74902-3101 · (479) 561-2448
Organization SubpartNo
Authorized OfficialShane WalkerOwner · (479) 561-2448
Enumeration DateMarch 22, 2018
NPI 1114421260 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinical Medical LaboratoryLaboratories
Taxonomy Code291U00000X
Definition
(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.
105 N POCOLA BLVD, Pocola, OK 74902

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Chiropractor
105 N POCOLA BLVD
POCOLA, OK 74902

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stateline Medical LLC's NPI number?

The NPI number for Stateline Medical LLC is 1114421260. It was assigned to this organization in the NPPES registry on March 22, 2018.

Where is Stateline Medical LLC located?

Stateline Medical LLC is located at 105 N Pocola Blvd Suite 2, Pocola, OK 74902. The listed phone number is (479) 561-2448.

What is Stateline Medical LLC's specialty?

The primary specialty registered for this NPI is Clinical Medical Laboratory with taxonomy code 291U00000X.

When was this NPI record last updated?

The NPPES record for Stateline Medical LLC was last updated on March 22, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.