MEDICARE: PERFORMANCE LABORATORIES LLC

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	:	1245657675
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERFORMANCE LABORATORIES LLC

Provider Business Mailing Address
First Line	:	500 NORTH WALKER AVENUE
Second Line	:	SUITE 150
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73102-1657
Country	:	US
Telephone Number	:	405-601-7100
Fax Number	:	405-601-7180

Provider Business Practice Location Address
First Line	:	500 NORTH WALKER AVENUE
Second Line	:	SUITE 150
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73102-1657
Country	:	US
Telephone Number	:	405-601-7100
Fax Number	:	405-601-7180

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	SAMIYA MUSTAFA
Credential	:
Telephone Number	:	770-557-2323

Provider Enumeration Date	:	03/24/2014
Last Update Date	:	09/19/2019

Similar Medicare Providers

1760620371 — DR. JARED JOHN BENNETT D.C.
Practice Location Address:

4045 NW 64TH ST STE 160
OKLAHOMA CITY, OK
73116-1657

Practice Phone: 405-659-5418
Practice Fax:

1487199758 — STEPHANIE STAMPER
Practice Location Address:

2001 S MACARTHUR BLVD TRLR 56
OKLAHOMA CITY, OK
73128-1657

Practice Phone: 405-985-5345
Practice Fax:

1891758710 — TOBY F HANDLER MD
Practice Location Address:

1305 FRANKLIN AVE , SUITE 100
GARDEN CITY, NY
11530-1657

Practice Phone: 516-746-5550
Practice Fax: 516-746-9641

1205892163 — MITCHELL D EFROS MD
Practice Location Address:

1305 FRANKLIN AVE
GARDEN CITY, NY
11530-1657

Practice Phone: 516-742-3200
Practice Fax: 516-746-5847

1922064880 — LOUIS FAIELLA MD
Practice Location Address:

1305 FRANKLIN AVE
GARDEN CITY, NY
11530-1657

Practice Phone: 516-742-3200
Practice Fax: 516-746-5847

1225094980 — ANTHONY M BRUNO MD
Practice Location Address:

1305 FRANKLIN AVE , SUITE 100
GARDEN CITY, NY
11530-1657

Practice Phone: 516-746-5550
Practice Fax: 516-746-9641

Directions to “PERFORMANCE LABORATORIES LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.