Laboratory Corporation of America
Organization Active NPI Clinical Medical Laboratory · Rapid City, SD
NPI 1609465012 · NPPES record last updated Jan 12, 2021
Key facts
- NPI
- 1609465012
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Medical Laboratory 291U00000X
- Legal business name
- LABORATORY CORPORATION OF AMERICA
- Practice address
- 2822 Jackson Blvd Ste 102
Rapid City, SD 57702-3497 - Phone
- (605) 341-1208
- Fax
- (605) 341-3552
- NPI assigned
- Jan 12, 2021
- Organization subpart
- No
Authorized official
- Name
- Kimberly T Williams
- Title
- Vice President
- Phone
- (800) 222-7566
Other NPIs on the same Medicare enrollment 1
Member of 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050323000119 | SD | Part B Supplier - Independent Clinical Laboratory | 2668379025 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Rapid City, SD |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Yes |
Addresses
Primary practice location
2822 Jackson Blvd Ste 102
Rapid City, SD 57702-3497
Mailing address
PO Box 2240
Burlington, NC 27216-2240
Phone (336) 436-5884
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43D2197896 | Other | CLIA |
Other providers in Rapid City, SD
- Nissa Kvidt
- Zita Elizabeth Kwartek
- Allison La Voie
- Katherine Labonte
- Laboratory Corporation of America
- Sonja Samsoondar Labrie
- Lac Castor Wellness, LLC
- Jaden Lafleur
- Taylor Lage
- Erika Lahood-Burns
All providers in Rapid City, SD · Clinical Medical Laboratory in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 12, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.