Labcorp Indiana Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

LABCORP INDIANA INC

Practice address

611 E Douglas Rd Ste 300
Mishawaka, IN 46545-1467

Phone

(574) 413-8066

Fax

(574) 335-6231

NPI assigned

Sep 12, 2019

Last updated

Oct 14, 2019By the provider in NPPES

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

Locations

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": "1659921617",
    "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": "611 E DOUGLAS RD STE 300",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451467",
            "telephone_number": "574-413-8066",
            "fax_number": "574-335-6231"
        }
    ],
    "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "15D2171138",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• April Kwiatkowski
• Destany Kyle
• Dung Trina La, PHARMD
• Labcorp Indiana Inc
• Labcorp Indiana Inc
• Laboratory Corporation of America
• Laboratory Corporation of America Holdings
• Susana Lagunas
• Sanjeev Shivaji Lahane, C.S.A.
• Cynthia Megan Lai, MD

• Clinical Medical Laboratory in Mishawaka, IN
• Providers in Mishawaka, 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.