NPIMap

Organization Active NPI

Cornerstone Diagnostics Inc

Doing business as Premier Tox 20 INC

  • Clinical Medical Laboratory
  • Jamestown, KY
National Provider Identifier
1023306347
Registry record updated Dec 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
CORNERSTONE DIAGNOSTICS INC
Doing business as
Cornerstone Diagnostics Inc
Premier Tox 20 INC
Premier Tox Laboratory
Practice address
812 N Main St
Jamestown, KY 42629-2404
Phone
(877) 412-8330
Fax
(844) 982-0300
NPI assigned
Jul 20, 2011
Last updated
Dec 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2025

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

Authorized official

Name
William Bouchillon
Title
Ceo
Phone
(877) 412-8330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

812 N Main St
Jamestown, KY 42629-2404

Mailing address

PO Box 1240
Russell Springs, KY 42642-1240
Phone (877) 412-8330

Other names 3

  • Cornerstone Diagnostics Inc Doing business as
  • Premier Tox 20 INC Doing business as
  • Premier Tox Laboratory Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120319000741 KY Part B Supplier - Independent Clinical Laboratory 8224202403 5 other NPIs on this enrollment
Practice locations: Jamestown, KY; Middlesboro, KY

Other NPIs on the same Medicare enrollment 5

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D2012989Cornerstone Diagnostics Inc812 N Main St, Jamestown, KY 42629AccreditationJul 12, 2028

National Provider Directory

National Provider Directory
Tax ID family
Premiertox Lab Albany4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2431 Lakeway Dr
Ste 17A1
Russell Springs, KY 42642

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1311120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767052800000",
    "number": "1023306347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1240",
            "city": "RUSSELL SPRINGS",
            "state": "KY",
            "postal_code": "426421240",
            "telephone_number": "877-412-8330",
            "fax_number": "844-982-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 N MAIN ST",
            "city": "JAMESTOWN",
            "state": "KY",
            "postal_code": "426292404",
            "telephone_number": "877-412-8330",
            "fax_number": "844-982-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE DIAGNOSTICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-20",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A",
        "authorized_official_last_name": "BOUCHILLON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "877-412-8330"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cornerstone Diagnostics Inc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Premier Tox 20 INC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Premier Tox Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jamestown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.