Active NPI
Laboratory Corporation of America
- Clinical Medical Laboratory
- Fairbanks, AK
National Provider Identifier
1669925012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- LABORATORY CORPORATION OF AMERICA
- Practice address
- 1626 30TH Ave
Fairbanks, AK 99701-7466 - Phone
- (907) 479-0332
- NPI assigned
- Aug 2, 2016
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Primary |
Addresses
Primary practice location
1626 30TH Ave
Fairbanks, AK 99701-7466
Mailing address
PO Box 2240
Burlington, NC 27216-2240
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02D2114926 | Other | CLIA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AK
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170221001660 | AK | Part B Supplier - Independent Clinical Laboratory | 2668379025 | Practice locations: Fairbanks, AK |
National Provider Directory
National Provider Directory- Tax ID family
- Reference Pathology Lab
Organizations with this tax ID in the same state 5
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- Clinical Medical Laboratory
- Anchorage, AK
- NPI 1225475270
-
- Clinical Medical Laboratory
- Anchorage, AK
- NPI 1245808302
-
- Clinical Medical Laboratory
- Anchorage, AK
- NPI 1306102355
-
- Clinical Medical Laboratory
- Anchorage, AK
- NPI 1356332878
-
- Clinical Medical Laboratory
- Anchorage, AK
- NPI 1467430645
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
- Clinical Medical Laboratory
- Cromwell, CT
- NPI 1700517984
Member Of
Locations
1626 30th Ave
Fairbanks, AK 99701
Phone (907) 479-0332
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470096000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1470096000000",
"number": "1669925012",
"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": "1626 30TH AVE",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997017466",
"telephone_number": "907-479-0332"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LABORATORY CORPORATION OF AMERICA",
"organizational_subpart": "NO",
"enumeration_date": "2016-08-02",
"last_updated": "2016-08-02",
"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": "02D2114926",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Fairbanks, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.