LABORATORY CORPORATION OF AMERICA
Complete NPI Record 1821982646
Clinical Medical Laboratory in Corvallis, OR

NPI Status: Active since June 05, 2025

Contact Information

2350 NW CENTURY DR STE 100
CORVALLIS, OR
ZIP 97330
Phone: (541) 754-1265

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Complete NPI Dataset

This page represents the complete record for NPI 1821982646. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1821982646
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: UNAVAIL
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider First Line Business Mailing Address: PO BOX 2240
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: BURLINGTON
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: NC
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 272162240
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider First Line Business Practice Location Address: 2350 NW CENTURY DR STE 100
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: CORVALLIS
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: OR
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 973303495
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 5417541265
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date: 6/5/2025
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 6/5/2025
The date that a record was last updated or changed.
Authorized Official Last Name: WILLIAMS
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: KIMBERLY
The first name of the authorized official.
Authorized Official Middle Name: T
The middle name of the authorized official.
Authorized Official Title or Position: VICE PRESIDENT
The title or position of the authorized official.
Authorized Official Telephone Number: 3364365402
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 291U00000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: Y
Other Provider Identifier 1: 38D0894793
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 1: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier Issuer 1: CLIA
Is Organization Subpart: N
NPI Certification Date: 6/5/2025