Organization Active NPI

Laboratory Corpoation of America

  • Clinical Medical Laboratory
  • Longview, WA
National Provider Identifier
1750653895
Registry record updated Feb 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
LABORATORY CORPOATION OF AMERICA
Practice address
1055 9TH Ave
Longview, WA 98632-2662
Phone
(360) 577-2658
NPI assigned
Feb 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. William B Hayes
Title
Cfo/Evp/Treasurer
Phone
(800) 222-7566

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

1055 9TH Ave
Longview, WA 98632-2662

Mailing address

PO Box 2240
Burlington, NC 27216-2240
Phone (800) 222-7566

Other identifiers 1

IdentifierTypeStateIssuer
50D2029654OtherCLIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040209000184 WA Part B Supplier - Independent Clinical Laboratory 2668379025 This NPI is an additional NPI on the enrollment
Practice locations: Tukwila, WA; Seattle, WA; Toppenish, WA; Sunnyside, WA; Spokane Valley, WA; Spokane, WA; Walla Walla, WA; Wapato, WA…

National Provider Directory

National Provider Directory

Locations

1055 9th Ave
Longview, WA 98632
Phone (360) 575-8275

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1328486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328486400000",
    "number": "1750653895",
    "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": "800-222-7566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 9TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322662",
            "telephone_number": "360-577-2658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORY CORPOATION OF AMERICA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-06",
        "last_updated": "2012-02-06",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CFO/EVP/TREASURER",
        "authorized_official_telephone_number": "800-222-7566",
        "authorized_official_name_prefix": "Mr."
    },
    "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": "50D2029654",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2012; 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.