Organization
LABORATORY CORPORATION OF AMERICA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY WILLIAMS (VICE PRESIDENT)
(336) 436-5761
Entity
Organization
Contact information
Practice address
4212 NE BROADWAY RM L100, PORTLAND, OR 97213-1422
(971) 361-3657
(206) 861-7367
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
—
38D2187633
CLIA
—
Enumeration date
07/15/2020
Last updated
07/21/2020
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