Laboratory Corporation of America Holdings

Organization Active NPI Clinical Medical Laboratory · Baton Rouge, LA

NPI 1164048740 · NPPES record last updated Jul 28, 2020

Key facts

NPI
1164048740
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Medical Laboratory 291U00000X
Legal business name
LABORATORY CORPORATION OF AMERICA HOLDINGS
Practice address
8415 Goodwood Blvd Ste 103
Baton Rouge, LA 70806-7851
Phone
(225) 935-0039
NPI assigned
Jun 19, 2020
Organization subpart
No

Authorized official

Name
Kimberly T Williams
Title
VP
Phone
(336) 436-5402

Other NPIs on the same Medicare enrollment 17

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

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
19D0463125Laboratory Corporation of America Holdings
8415 Goodwood Boulevard, Suite 103, Baton Rouge, LA 70806
ComplianceMar 23, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in LA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040305000728 LA Part B Supplier - Independent Clinical Laboratory 8729991757 17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Monroe, LA; West Monroe, LA

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Yes

Addresses

Primary practice location

8415 Goodwood Blvd Ste 103
Baton Rouge, LA 70806-7851

Mailing address

PO Box 2240
Burlington, NC 27216-2240
Phone (336) 222-7566

Other identifiers

IdentifierTypeStateIssuer
19D0463125OtherCLIA

Other providers in Baton Rouge, LA

All providers in Baton Rouge, LA · Clinical Medical Laboratory in Louisiana

Sources for this page

Verify at the official NPI Registry.