NPIMap

Organization Active NPI

Laboratory Corporation of America Holdings

  • Clinical Medical Laboratory
  • Clayton, NC
National Provider Identifier
1952861999
Registry record updated Apr 25, 2019
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
236 Butternut LN
Clayton, NC 27520-5857
Phone
(919) 585-4134
Fax
(919) 359-9122
NPI assigned
Mar 25, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2019

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
(336) 436-5402

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

236 Butternut LN
Clayton, NC 27520-5857

Mailing address

PO Box 2240
Burlington, NC 27216-2240

Other identifiers 1

IdentifierTypeStateIssuer
34D2163231OtherCLIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121203000416 NC Part B Supplier - Independent Clinical Laboratory 8729991757 15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Reidsville, NC; Raleigh, NC; Mount Olive, NC; Clayton, NC; Cary, NC; Kannapolis, NC

Other NPIs on the same Medicare enrollment 15

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

View all 15

National Provider Directory

National Provider Directory

Locations

236 Butternut Ln
Clayton, NC 27520
Phone (919) 359-1011

NPI Registry JSON

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556150400000",
    "number": "1952861999",
    "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": "236 BUTTERNUT LN",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275205857",
            "telephone_number": "919-585-4134",
            "fax_number": "919-359-9122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORY CORPORATION OF AMERICA HOLDINGS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-25",
        "last_updated": "2019-04-25",
        "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": "336-436-5402"
    },
    "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": "34D2163231",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clayton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2019; 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.