Opko Lab, LLC

Debarred entity

United States. Named in 6 sanctions listings.

Summary

KMAP Provider Number 201083740C; 201083740B; 201083740A

Sanctions and listings6

Effective
31 May 2016
Official designation
Mississippi Division of MedicaidUS Mississippi Medicaid Terminated Provider ListUnited States
Exclusion by Other Agencies or Programs
medicaid.ms.gov
Effective
29 Mar 2017
Official designation
Louisiana Department of HealthUS Louisiana Department of Health Adverse Actions ListUnited States
Termination of Provider Enrollment Agreement
adverseactions.ldh.la.gov
Effective
31 May 2016
Official designation
Mississippi Division of MedicaidUS Mississippi Medicaid Terminated Provider ListUnited States
Exclusion by Other Agencies or Programs
medicaid.ms.gov
Effective
23 Mar 2017
Official designation
South Carolina Department of Health and Human ServicesUS South Carolina Excluded ProvidersUnited StatesTerminated for cause
scdhhs.gov
Effective
29 Apr 2019
Official designation
Kansas Department of Health and EnvironmentUS Kansas Medicaid Terminated Provider ListUnited States
Loss of license or other State action.
kdhe.ks.gov
Effective
30 Dec 2016
Official designation
Indiana Family and Social Services AdministrationUS Indiana Medicaid Terminated Provider ListUnited States
in.gov

Identifiers3

Identifier	Number
NPI number	1104166354
NPI number	1679813828
NPI number	1477893626

Other names1

Also known as1

Opko Ourlab LLC

Addresses4

1450 Elm Hill Pike
875 Cowan Road
Burlingame, CA 94010
Nashville, TN

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