OrganizationActive
Stateline Medical LLC
NPI 1114421260 · Clinical Medical Laboratory · Pocola, OK
Stateline Medical LLC is a Clinical Medical Laboratory organization in Pocola, OK (NPI 1114421260).
Provider details
- NPI number
- 1114421260
- Entity type
- Organization
- Primary specialty
- Clinical Medical LaboratoryLaboratories
- Organization subpart
- No
- Authorized official
- Shane Walker, Owner(479) 561-2448
Specialties & taxonomies
Laboratories
Profile Score
Established profile(68/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
105 N Pocola Blvd
Suite 2
Pocola, OK 74902-3101
Phone: (479) 561-2448
Approximate (ZIP-level) locationGet directions
Mailing address
105 N Pocola Blvd
Pocola, OK 74902-3101
Registry dates
- Enumerated
- 2018-03-22
- Last updated
- 2018-03-22
Frequently asked questions
- What is Stateline Medical LLC's NPI number?
- Stateline Medical LLC's National Provider Identifier (NPI) is 1114421260, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Stateline Medical LLC?
- Stateline Medical LLC is classified in the NPPES registry as Clinical Medical Laboratory (Laboratories).
- Where is Stateline Medical LLC located?
- Stateline Medical LLC's practice location on file with NPPES is 105 N Pocola Blvd, Pocola, OK 74902-3101.
- What is Stateline Medical LLC's phone number?
- The practice phone number listed in the NPPES registry for Stateline Medical LLC is (479) 561-2448.
- Who is the authorized official for Stateline Medical LLC?
- The authorized official listed on Stateline Medical LLC's NPPES record is Shane Walker, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Stateline Medical LLC's NPI active?
- Yes — Stateline Medical LLC's NPI (1114421260) is active in the NPPES registry as of the last update on 2018-03-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.