Provider Demographics
NPI:1093896763
Name:LABORATORY CORPORATION OF AMERICA
Entity Type:Organization
Organization Name:LABORATORY CORPORATION OF AMERICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO/EVP TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:B
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:800-222-7566
Mailing Address - Street 1:10310 W MARKHAM ST
Mailing Address - Street 2:SUITE 195
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-2175
Mailing Address - Country:US
Mailing Address - Phone:501-954-9774
Mailing Address - Fax:
Practice Address - Street 1:10310 W MARKHAM ST
Practice Address - Street 2:SUITE 195
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-2175
Practice Address - Country:US
Practice Address - Phone:501-954-9774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR18128Medicare PIN