MEDICARE: AFFORDABLE LAB OKLAHOMA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1760338073
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AFFORDABLE LAB OKLAHOMA

Provider Business Mailing Address
First Line	:	3201 N VAN BUREN ST STE 100
Second Line	:
City	:	ENID
State	:	OK
Zip	:	73703-1800
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3201 N VAN BUREN ST STE 100
Second Line	:
City	:	ENID
State	:	OK
Zip	:	73703-1800
Country	:	US
Telephone Number	:	708-765-4483
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BENJAMIN VILLAFANE JR.
Credential	:
Telephone Number	:	708-765-4483

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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Directions to “AFFORDABLE LAB OKLAHOMA ” Practice Location

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