Organization Active NPI

Laboratory Corporation of America

  • Clinical Medical Laboratory
  • Arlington, TX
National Provider Identifier
1114588605
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
LABORATORY CORPORATION OF AMERICA
Practice address
3201 Matlock Rd Ste 210
Arlington, TX 76015-2946
Phone
(817) 419-2598
Fax
(817) 419-2632
NPI assigned
Jun 25, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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
(800) 222-7566

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

3201 Matlock Rd Ste 210
Arlington, TX 76015-2946

Mailing address

PO Box 2240
Burlington, NC 27216-2240

Other identifiers 1

IdentifierTypeStateIssuer
45D2167579OtherCLIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100525000384 TX Part B Supplier - Independent Clinical Laboratory 2668379025 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Arlington, TX; Irving, TX
O20161205002005 TX Part B Supplier - Independent Clinical Laboratory 2668379025 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Arlington, TX; Cleveland, TX; Fort Worth, TX

Other NPIs on the same Medicare enrollment 8

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

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1561420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632355200000",
    "number": "1114588605",
    "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": "3201 MATLOCK RD STE 210",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760152946",
            "telephone_number": "817-419-2598",
            "fax_number": "817-419-2632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORY CORPORATION OF AMERICA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-25",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "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": "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": "45D2167579",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; 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.