NPIMap

Organization Active NPI

Laboratory Corporation of America Holdings

  • Clinical Medical Laboratory
  • Princeton, WV
National Provider Identifier
1427412477
Registry record updated Apr 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
LABORATORY CORPORATION OF AMERICA HOLDINGS
Practice address
200 12TH Street Ext
Room 116
Princeton, WV 24740-2329
Phone
(304) 425-0100
NPI assigned
Apr 6, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2016

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

200 12TH Street Ext
Room 116
Princeton, WV 24740-2329

Mailing address

PO Box 2240
Burlington, NC 27216-2240

Other identifiers 1

IdentifierTypeStateIssuer
51D2110439OtherCLIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160610001903 WV Part B Supplier - Independent Clinical Laboratory 8729991757 Practice locations: Princeton, WV

National Provider Directory

National Provider Directory
Tax ID family
Labcorp of Am Holdings-KS257 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 7

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

Locations

200 12th Street Ext
Rm 116
Princeton, WV 24740
Phone (304) 425-0100

200 12th Street Ext
Ste 116
Princeton, WV 24740
Phone (304) 425-0100

Networks

  • HealthSun Health Plans Network

NPI Registry JSON

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

{
    "created_epoch": "1459900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461024000000",
    "number": "1427412477",
    "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": "200 12TH STREET EXT",
            "address_2": "ROOM 116",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402329",
            "telephone_number": "304-425-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORY CORPORATION OF AMERICA HOLDINGS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-06",
        "last_updated": "2016-04-19",
        "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": "51D2110439",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2016; 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.