NPIMap

Organization Active NPI

Laboratory Corporation of America

  • Clinical Medical Laboratory
  • Junction City, OR
National Provider Identifier
1790200947
Registry record updated Dec 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
LABORATORY CORPORATION OF AMERICA
Practice address
355 W 3Rd Ave
Junction City, OR 97448-1313
Phone
(541) 234-2411
NPI assigned
Aug 9, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2017

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)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

355 W 3Rd Ave
Junction City, OR 97448-1313

Mailing address

PO Box 2240
Burlington, NC 27216-2240

Other identifiers 1

IdentifierTypeStateIssuer
38D2133306OtherCLIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040130001011 OR Part B Supplier - Independent Clinical Laboratory 2668379025 34 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Junction City, OR; Philomath, OR; Portland, OR; Salem, OR; Springfield, OR; Woodburn, OR; Astoria, OR; Albany, OR…

Other NPIs on the same Medicare enrollment 34

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

View all 34

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D2133306Laboratory Corporation of America355 W 3Rd Ave, Junction City, OR 97448Certificate of waiverJul 9, 2027

National Provider Directory

National Provider Directory
Tax ID family
Reference Pathology Lab274 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 19

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1502236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512518400000",
    "number": "1790200947",
    "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": "355 W 3RD AVE",
            "city": "JUNCTION CITY",
            "state": "OR",
            "postal_code": "974481313",
            "telephone_number": "541-234-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORY CORPORATION OF AMERICA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-09",
        "last_updated": "2017-12-06",
        "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": "38D2133306",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Junction City, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.