Organization Active NPI

Laboratory Corporation of America Holdings

  • Clinical Medical Laboratory
  • West Monroe, LA
National Provider Identifier
1679199715
Registry record updated Jun 24, 2020
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
107 Contempo Ave Ste B
West Monroe, LA 71291-5383
Phone
(318) 398-1665
Fax
(318) 329-8094
NPI assigned
Jun 24, 2020
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Kimberly T Williams
Title
VP
Phone
(336) 222-7566

Other NPIs on the same Medicare enrollment 17

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 17

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040305000728 LA Part B Supplier - Independent Clinical Laboratory 8729991757 17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Monroe, LA; West Monroe, LA

National Provider Directory

National Provider Directory

Locations

107 Contempo Ave
Ste B
West Monroe, LA 71291
Phone (318) 388-5030

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

107 Contempo Ave Ste B
West Monroe, LA 71291-5383

Mailing address

PO Box 2240
Burlington, NC 27216-2240
Phone (336) 222-7566

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
19D2049335OtherCLIA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 24, 2020.

{
    "created_epoch": "1592956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592956800000",
    "number": "1679199715",
    "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",
            "telephone_number": "336-222-7566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 CONTEMPO AVE STE B",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712915383",
            "telephone_number": "318-398-1665",
            "fax_number": "318-329-8094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORY CORPORATION OF AMERICA HOLDINGS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-24",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "336-222-7566"
    },
    "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": "19D2049335",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Monroe, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; 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.