Organization
LABORATORY CORPORATION OF AMERICA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY T WILLIAMS (VICE PRESIDENT)
(336) 436-5402
Entity
Organization
Contact information
Practice address
780 S APOLLO BLVD STE 204, MELBOURNE, FL 32901-1404
(321) 557-9130
Mailing address
PO BOX 2240, BURLINGTON, NC 27216-2240
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10D2309717
CLIA
FL
Enumeration date
08/19/2024
Last updated
09/11/2024
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