Healthcare Provider Details

I. General information

NPI: 1093793200
Provider Name (Legal Business Name): LABORATORY CORPORATION OF AMERICA HOLDINGS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 02/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 SUMMER ST
WORCESTER MA
01608-1216
US

IV. Provider business mailing address

PO BOX 2240
BURLINGTON NC
27216-2240
US

V. Phone/Fax

Practice location:
  • Phone: 508-363-6194
  • Fax:
Mailing address:
  • Phone: 800-222-7566
  • Fax: 336-436-1048

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier22D0966206
Identifier TypeOTHER
Identifier StateMA
Identifier IssuerCLIA

VIII. Authorized Official

Name: KIMBERLY WILLIAMS
Title or Position: VP
Credential:
Phone: 800-222-7566