NPI Code Details Logo

NPI 1760338073

NPI 1760338073 : AFFORDABLE LAB OKLAHOMA : ENID, OK

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1760338073
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    AFFORDABLE LAB OKLAHOMA 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    03/09/2026
-----------------------------------------------------
    Last Update Date     |    03/09/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    3201 N VAN BUREN ST STE 100 
-----------------------------------------------------
    City                 |    ENID
-----------------------------------------------------
    State                |    OK
-----------------------------------------------------
    Zip                  |    73703-1800
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    708-765-4483
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

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

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

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    291U00000X
-----------------------------------------------------
    Taxonomy Name        |    Clinical Medical Laboratory
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.