Healthcare Provider Details

I. General information

NPI: 1568779718
Provider Name (Legal Business Name): LABORATORY CORPORATION OF AMERICA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2010
Last Update Date: 08/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1427 JEFFERSON AVE STE 102
ENUMCLAW WA
98022-3649
US

IV. Provider business mailing address

PO BOX 2240
BURLINGTON NC
27216-2240
US

V. Phone/Fax

Practice location:
  • Phone: 360-542-3232
  • Fax:
Mailing address:
  • Phone: 800-222-7566
  • Fax:

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
Identifier50D2009386
Identifier TypeOTHER
Identifier State
Identifier IssuerCLIA

VIII. Authorized Official

Name: MR. WILLIAM B HAYES
Title or Position: CFO EVP TREASURER
Credential:
Phone: 800-222-7566