Provider Demographics
NPI:1972497121
Name:CIARA LABS
Entity type:Organization
Organization Name:CIARA LABS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TRENTON
Authorized Official - Middle Name:
Authorized Official - Last Name:STILLWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-306-4461
Mailing Address - Street 1:11425 E 20TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74128-6438
Mailing Address - Country:US
Mailing Address - Phone:918-439-9229
Mailing Address - Fax:918-437-8188
Practice Address - Street 1:11425 E 20TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74128-6438
Practice Address - Country:US
Practice Address - Phone:918-439-9229
Practice Address - Fax:918-437-8188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-04
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory