Basic Information
| Provider Information | |||||||||
| NPI: | 1104829159 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LABORATORY CORPORATION OF AMERICA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2240 | ||||||||
| Address2: | |||||||||
| City: | BURLINGTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272162240 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002227566 | ||||||||
| FaxNumber: | 3364361048 | ||||||||
| Practice Location | |||||||||
| Address1: | 531 S SPRING ST | ||||||||
| Address2: | |||||||||
| City: | BURLINGTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272155866 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002227566 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2005 | ||||||||
| LastUpdateDate: | 11/07/2017 | ||||||||
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| AuthorizedOfficialLastName: | WILLIAMS | ||||||||
| AuthorizedOfficialFirstName: | KIMBERLY | ||||||||
| AuthorizedOfficialMiddleName: | T | ||||||||
| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3364365402 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 291U00000X | Y | Laboratories | Clinical Medical Laboratory |
No ID Information.