Laboratory Corporation of America Holdings

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

LABORATORY CORPORATION OF AMERICA HOLDINGS

Practice address

1320 S Wisconsin St
Hobart, IN 46342-5502

Phone

(219) 945-9180

Fax

(219) 661-8066

NPI assigned

Oct 27, 2020

Organization subpart

No

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

Authorized official

Name

Kimberly T Williams

Title

Vice President

Phone

(336) 436-5402

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1603756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603756800000",
    "number": "1073113379",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 S WISCONSIN ST",
            "city": "HOBART",
            "state": "IN",
            "postal_code": "463425502",
            "telephone_number": "219-945-9180",
            "fax_number": "219-661-8066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORY CORPORATION OF AMERICA HOLDINGS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-27",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "336-436-5402"
    },
    "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": "15D2111960",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina M Korem, FNP-C
• Maureen Kozlow, PA-C
• Mary P Kustron
• Fadee Kutom, MD
• Labcorp Indiana Inc
• Lake Park Clinic, P.C.
• Lake Park Dental Group
• Lake Park Surgicare, LLC
• Lakeshore Anesthesia, P.C.
• Mariah Landeros, RBT

• Clinical Medical Laboratory in Hobart, IN
• Providers in Hobart, IN by specialty
• Clinical Medical Laboratory in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.