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

General Provider Information

NPI Number	:	1104804319
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	:	800-222-7566
Fax Number	:	336-436-1048

Provider Business Practice Location Address
First Line	:	2720 SW 97TH AVE
Second Line	:	STE 204
City	:	MIAMI
State	:	FL
Zip	:	33165-2677
Country	:	US
Telephone Number	:	305-220-3074
Fax Number	:

Authorized Official
Title or Position	:	CFO/EVP/ TREASURER
Name	:	WILLIAM B HAYES
Credential	:
Telephone Number	:	800-222-7566

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	08/17/2007

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Directions to “LABORATORY CORPORATION OF AMERICA ” Practice Location

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