Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Stateline Medical LLC

Organization Clinical Medical Laboratory · NPI 1114421260

Stateline Medical LLC is a Clinical Medical Laboratory in Pocola, Oklahoma. Licensed in Oklahoma. Registered with an NPI since 2018.

Licensed in
OK
In the registry since
2018
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

105 N Pocola Blvd Ste 2
Pocola, OK 74902-3101
Phone: (479) 561-2448
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Medical Laboratory (primary) Taxonomy 291U00000X (OK)

Record details

NPI number1114421260
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Shane Walker — Owner · (479) 561-2448
NPI enumeratedMarch 22, 2018
Last updated in NPPESMarch 22, 2018
Mailing address105 N Pocola Blvd, Suite 2, Pocola, OK 74902-3101

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