Provider Demographics
NPI:1750153441
Name:OKC FERTILITY LAB LLC
Entity type:Organization
Organization Name:OKC FERTILITY LAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANA
Authorized Official - Middle Name:N
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-724-7102
Mailing Address - Street 1:3330 NW 56TH ST STE 600
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4473
Mailing Address - Country:US
Mailing Address - Phone:405-724-7102
Mailing Address - Fax:405-724-7996
Practice Address - Street 1:3330 NW 56TH ST STE 600
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4473
Practice Address - Country:US
Practice Address - Phone:405-724-7102
Practice Address - Fax:405-724-7996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical Laboratory
No207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Multi-Specialty