MEDICARE: MERIDIAN LABORATORY CORP

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	34D0999131	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477556876
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERIDIAN LABORATORY CORP

Provider Business Mailing Address
First Line	:	2401 WHITEHALL PARK DRIVE
Second Line	:	SUITE 700
City	:	CHARLOTTE
State	:	NC
Zip	:	28273-3416
Country	:	US
Telephone Number	:	704-992-0708
Fax Number	:	704-749-2332

Provider Business Practice Location Address
First Line	:	2401 WHITEHALL PARK DRIVE
Second Line	:	SUITE 700
City	:	CHARLOTTE
State	:	NC
Zip	:	28273-3416
Country	:	US
Telephone Number	:	704-992-0708
Fax Number	:	704-749-2332

Authorized Official
Title or Position	:	EXECUTIVE VP OPERATIONS
Name	:	MARGIE SADLER
Credential	:	MT(ASCP)
Telephone Number	:	704-992-0708

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	06/26/2015

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Directions to “MERIDIAN LABORATORY CORP ” Practice Location

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