MEDICARE: LABORATORY CORPORATION OF AMERICA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	23D2219162	OTHER		CLIA

General Provider Information

NPI Number	:	1336720671
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LABORATORY CORPORATION OF AMERICA

Provider Business Mailing Address
First Line	:	PO BOX 2240
Second Line	:
City	:	BURLINGTON
State	:	NC
Zip	:	27216-2240
Country	:	US
Telephone Number	:	336-436-5884
Fax Number	:

Provider Business Practice Location Address
First Line	:	4290 COPPER RIDGE DR STE 120
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49684-7205
Country	:	US
Telephone Number	:	855-841-0475
Fax Number	:	248-888-9039

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	KIMBERLY T WILLIAMS
Credential	:
Telephone Number	:	800-222-7566

Provider Enumeration Date	:	04/19/2021
Last Update Date	:	04/28/2021

Similar Medicare Providers

1336159102 — DR. TOBIN J FRASER DO
Practice Location Address:

4290 COPPER RIDGE DR STE 200
TRAVERSE CITY, MI
49684-7205

Practice Phone: 231-935-8930
Practice Fax: 231-935-8811

1851490296 — WEST FRONT PRIMARY CARE, P.L.L.C.
Practice Location Address:

4290 COPPER RIDGE DR STE 200
TRAVERSE CITY, MI
49684-7205

Practice Phone: 231-935-8930
Practice Fax: 231-935-8811

1932994217 — SIC OF MICHIGAN, PC
Practice Location Address:

4290 COPPER RIDGE DR STE 130
TRAVERSE CITY, MI
49684-7205

Practice Phone: 231-252-0893
Practice Fax:

1821096843 — MR. DOUGLAS E ARNOLD PT ATC
Practice Location Address:

6801 N CLASSEN BLVD , SUITE B
OKLAHOMA CITY, OK
73116-7205

Practice Phone: 405-810-2902
Practice Fax: 405-810-2905

1023018017 — MARILYN JEAN KLEIN FNPC
Practice Location Address:

1670 BONANZA DR
PARK CITY, UT
84060-7205

Practice Phone: 435-649-5989
Practice Fax: 435-649-5991

1578534996 — MR. JIMMY PIERCEY PT
Practice Location Address:

6801 N CLASSEN BLVD , STE B
OKLAHOMA CITY, OK
73116-7205

Practice Phone: 405-810-2902
Practice Fax: 405-810-2905

Directions to “LABORATORY CORPORATION OF AMERICA ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.