Labcorp Indiana Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

LABCORP INDIANA INC

Practice address

1506 Osolo Rd Ste a
Elkhart, IN 46514-4122

Phone

(574) 370-7957

NPI assigned

Sep 12, 2019

Organization subpart

No

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

Addresses

Other identifiers 1

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

{
    "created_epoch": "1568246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571011200000",
    "number": "1609426667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 MAPLE AVE",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272155848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 OSOLO RD STE A",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465144122",
            "telephone_number": "574-370-7957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABCORP INDIANA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-12",
        "last_updated": "2019-10-14",
        "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": "15D1002895",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin Beth Kuntz, NP
• Sabu Kurian, CRNA
• David Joseph Kustron, PTA
• Breann Marie Kutzer McManus, CRNA
• Fungai Kwanai, CRNA
• Laboratory Corporation of America Holdings
• Lillian Lacey
• Bridget Ladewski, BSW
• Charmagne Alee Lafortune, M.S.ED
• Lakeshore Eyecare, Inc.

• Clinical Medical Laboratory in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Clinical Medical Laboratory in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.