Basic Information
| Provider Information | |||||||||
| NPI: | 1174740542 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LABORATORY CORPORATION OF AMERICA HOLDINGS | ||||||||
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| OtherOrganizationName: | ALBANY CYTOPATH | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2240 | ||||||||
| Address2: | |||||||||
| City: | BURLINGTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272162240 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002227566 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 400 PATROON CREEK BLVD | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 122065013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5187839189 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/19/2007 | ||||||||
| LastUpdateDate: | 06/03/2008 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | HAYES | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
| AuthorizedOfficialMiddleName: | B | ||||||||
| AuthorizedOfficialTitleorPosition: | CFO EVP TREASURER | ||||||||
| AuthorizedOfficialTelephone: | 8002227566 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | LABORATORY CORPORATION OF AMERICA HOLDINGS | ||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 291U00000X | Y | Laboratories | Clinical Medical Laboratory |
ID Information
| ID | Type | State | Issuer | Description | 33D0162090 | 01 | NY | CLIA | OTHER |