NPIMap

Cornerstone Diagnostics Inc

Organization Active NPI Clinical Medical Laboratory · Jamestown, KY

NPI 1023306347 · NPPES record last updated Dec 30, 2025

Key facts

NPI
1023306347
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Medical Laboratory 291U00000X
Legal business name
CORNERSTONE DIAGNOSTICS INC
Practice address
812 N Main St
Jamestown, KY 42629-2404
Phone
(877) 412-8330
Fax
(844) 982-0300
NPI assigned
Jul 20, 2011
Organization subpart
No

Authorized official

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

Other NPIs on the same Medicare enrollment 5

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

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.

Corporate family (same tax ID) 3

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

Laboratory certificates & supplier records

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

CLIA laboratory certificates

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in KY

Medicare enrollment records

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

National Provider Directory

Tax ID family
Premiertox Lab Albany (4 organizations share this tax ID)

Locations

2431 Lakeway Dr
Ste 17A1
Russell Springs, KY 42642

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Yes

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 identifiers

IdentifierTypeStateIssuer
7100198710MedicaidKY

Other names

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

Other providers in Jamestown, KY

All providers in Jamestown, KY · Clinical Medical Laboratory in Kentucky

Sources for this page

Verify at the official NPI Registry.