Active NPI
Laboratory Corporation of America
- Clinical Medical Laboratory
- Saint Louis, MO
National Provider Identifier
1164032744
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- LABORATORY CORPORATION OF AMERICA
- Practice address
- 3009 N Ballas Rd Ste 100B
Saint Louis, MO 63131-2322 - Phone
- (314) 266-3228
- NPI assigned
- Aug 7, 2020
- Organization subpart
- No
NPPES NPI Registry
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) 436-5761
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Primary |
Addresses
Primary practice location
3009 N Ballas Rd Ste 100B
Saint Louis, MO 63131-2322
Mailing address
PO Box 2240
Burlington, NC 27216-2240
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 26D2188705 | Other | CLIA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070108000187 | MO | Part B Supplier - Independent Clinical Laboratory | 2668379025 |
4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Saint Louis, MO |
Other NPIs on the same Medicare enrollment 4
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Clinical Medical Laboratory
- Lake St Louis, MO
- NPI 1164084711
O20070108000187
-
- Clinical Medical Laboratory
- Earth City, MO
- NPI 1235114778
O20070108000187
-
- Clinical Medical Laboratory
- Saint Louis, MO
- NPI 1376848481
O20070108000187
-
- Clinical Medical Laboratory
- Saint Louis, MO
- NPI 1942694658
O20070108000187
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596758400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1596758400000",
"number": "1164032744",
"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": "3009 N BALLAS RD STE 100B",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631312322",
"telephone_number": "314-266-3228"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LABORATORY CORPORATION OF AMERICA",
"organizational_subpart": "NO",
"enumeration_date": "2020-08-07",
"last_updated": "2020-08-07",
"certification_date": "2020-08-07",
"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": "336-436-5761"
},
"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": "26D2188705",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2020; 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.