Laboratory Corporation of America
Organization Active NPI Clinical Medical Laboratory · Post Falls, ID
NPI 1740643550 · NPPES record last updated Apr 7, 2016
Key facts
- NPI
- 1740643550
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Medical Laboratory 291U00000X
- Legal business name
- LABORATORY CORPORATION OF AMERICA
- Practice address
- 1641 E Polston Ave
Post Falls, ID 83854-6245 - Phone
- (208) 457-0545
- NPI assigned
- Mar 30, 2016
- Organization subpart
- No
Authorized official
- Name
- Kimberly T Williams
- Title
- Vice President
- Phone
- (800) 222-7566
Other NPIs on the same Medicare enrollment 11
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040622001382 | ID | Part B Supplier - Independent Clinical Laboratory | 2668379025 |
11 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Meridian, ID |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Yes |
Addresses
Primary practice location
1641 E Polston Ave
Post Falls, ID 83854-6245
Mailing address
PO Box 2240
Burlington, NC 27216-2240
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13D2106723 | Other | CLIA |
Other providers in Post Falls, ID
- Kootenai Prosthetic Orthotic Services Inc
- Kootenai Urgent Care LLC
- Nathan Christopher Kubej
- Laboratory Corporation of America
- Laboratory Corporation of America
- Laboratory Corporation of America
- Wade Lachman
- David E Laisy
- Christina Michelle Cuzick Lake
- Destiny Noelle Lake
All providers in Post Falls, ID · Clinical Medical Laboratory in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 7, 2016. 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.