NPIMap

Organization Active NPI

Laboratory Corporation of America Holdings

  • Clinical Medical Laboratory
  • Georgetown, SC
National Provider Identifier
1013261072
Registry record updated Dec 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
LABORATORY CORPORATION OF AMERICA HOLDINGS
Practice address
1075 N Fraser St
Suite a
Georgetown, SC 29440-2848
Phone
(843) 520-1973
NPI assigned
Oct 30, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kimberly Williams
Title
VP
Phone
(800) 222-7566

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

1075 N Fraser St
Suite a
Georgetown, SC 29440-2848

Mailing address

PO Box 2240
Burlington, NC 27216-2240
Phone (800) 222-7566

Other identifiers 1

IdentifierTypeStateIssuer
42D2047464OtherCLIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050203000473 SC Part B Supplier - Independent Clinical Laboratory 8729991757 16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Florence, SC; Myrtle Beach, SC; North Charleston, SC; West Columbia, SC

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory

Locations

1075 N Fraser St
Ste A
Georgetown, SC 29440
Phone (843) 520-1973

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387324800000",
    "number": "1013261072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2240",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272162240",
            "telephone_number": "800-222-7566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 N FRASER ST",
            "address_2": "SUITE A",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294402848",
            "telephone_number": "843-520-1973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORY CORPORATION OF AMERICA HOLDINGS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-30",
        "last_updated": "2013-12-18",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "800-222-7566"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "42D2047464",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.