NPIMap

Organization Active NPI

Laboratory Corporation of America

  • Clinical Medical Laboratory
  • Evergreen, CO
National Provider Identifier
1104526987
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
LABORATORY CORPORATION OF AMERICA
Practice address
32135 Castle CT Ste 101
Evergreen, CO 80439-8006
Phone
(720) 602-0494
NPI assigned
Mar 9, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

32135 Castle CT Ste 101
Evergreen, CO 80439-8006

Mailing address

PO Box 2270
Burlington, NC 27216-2270

Other identifiers 1

IdentifierTypeStateIssuer
06D2273303OtherCLIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050620000987 CO Part B Supplier - Independent Clinical Laboratory 2668379025 39 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Arvada, CO; Westminster, CO; Louisville, CO; Lone Tree, CO; Littleton, CO; Lakewood, CO; Golden, CO; Evergreen, CO…

Other NPIs on the same Medicare enrollment 39

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

View all 39

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
06D2273303Laboratory Corporation of America32135 Castle Court NBR 101, Evergreen, CO 80439Certificate of waiverDec 11, 2026

National Provider Directory

National Provider Directory
Tax ID family
Reference Pathology Lab274 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 13

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1678320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707264000000",
    "number": "1104526987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2270",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272162270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32135 CASTLE CT STE 101",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "804398006",
            "telephone_number": "720-602-0494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORY CORPORATION OF AMERICA",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-09",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "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": "06D2273303",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; 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.