Provider Demographics
| NPI: | 1386629392 |
|---|---|
| Name: | LABORATORY CORPORATION OF AMERICA HOLDINGS |
| Entity type: | Organization |
| Organization Name: | LABORATORY CORPORATION OF AMERICA HOLDINGS |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CFO/EVP/ TREASURER |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | WILLIAM |
| Authorized Official - Middle Name: | B |
| Authorized Official - Last Name: | HAYES |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 800-222-7566 |
| Mailing Address - Street 1: | PO BOX 2240 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | BURLINGTON |
| Mailing Address - State: | NC |
| Mailing Address - Zip Code: | 27216-2240 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 800-222-7566 |
| Mailing Address - Fax: | 336-436-1048 |
| Practice Address - Street 1: | 501 LOCUST AVE |
| Practice Address - Street 2: | |
| Practice Address - City: | FAIRMONT |
| Practice Address - State: | WV |
| Practice Address - Zip Code: | 26554-4719 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 304-366-0291 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2005-12-13 |
| Last Update Date: | 2007-08-16 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 291U00000X | Laboratories | Clinical Medical Laboratory |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| WV | D518121 | Medicare PIN |