MARLENE KING CHISHOLM, RN — NPI 1326937137 (CLIA-Certified Diagnostic Medical & Pathology Laboratory in MOUNT HOLLY, NC)

CMS-1500 Box 24J / 33a • NPI

1326937137

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

291U00000X (CMS 69)

CLIA-Certified Diagnostic Medical & Pathology Laboratory

Box 32 Service Location & ZIP+4

16 OAK GROVE ST UNIT 8, MOUNT HOLLY, NC, 28120-1655

✓ 9-Digit EDI 837 ZIP+4 (28120-1655)

Practice Phone & Referral Fax

(980) 437-4109

Fax: (888) 830-7437

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1326937137 (MARLENE KING CHISHOLM, RN) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1326937137` (NPI-1 Individual Practitioner)
Provider / Legal Name	MARLENE KING CHISHOLM, RN
Plain-English Specialty	CLIA-Certified Diagnostic Medical & Pathology Laboratory NUCC Code: `291U00000X` (Clinical Medical Laboratory)
Certifying / Licensing Body	CMS CLIA / College of American Pathologists (CAP)
Practice Location Address	16 OAK GROVE ST UNIT 8, MOUNT HOLLY, NC, 28120-1655
Practice Telephone / Fax	Tel: (980) 437-4109 \| Fax: (888) 830-7437
Administrative Mailing Address	905 CASSIDY DR, GASTONIA, NC, 28054-4306
Enumeration & Last Sync	Enumerated: 2025-06-30 \| CMS Record Updated: 2026-01-14

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

16 OAK GROVE ST UNIT 8, MOUNT HOLLY, NC, 28120-1655

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Plain-English Taxonomy & CMS Crosswalk (291U00000X)

What Does Taxonomy Code 291U00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 291U00000X translates to:
"CLIA-Certified Diagnostic Medical & Pathology Laboratory"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 69 (Clinical Laboratory) • CMS Code B4[14] (Histocompatibility Laboratory)
Certifying / Accrediting Authority: CMS CLIA / College of American Pathologists (CAP)
Clinical Scope: Fasting blood tests, bilirubin and liver function tests, kidney function (creatinine/eGFR), urine culture and sensitivity, or PCR molecular diagnostics.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (MARLENE KING CHISHOLM, RN)

Typical CPT / Diagnostic Procedures:

Complete Blood Count (CBC) with Automated Differential (CPT 85025)
Comprehensive Metabolic Panel (CMP), Fractionated Bilirubin & Hepatic Panel
Quantitative Urine Culture & Colony Count (≥ 10⁵ CFU/mL) with Antibiotic Susceptibility
HbA1c, Lipid Panel, TSH & High-Sensitivity Troponin Assays

Common Therapeutic Classes:

Diagnostic Reagent Panels & CLSI Antimicrobial Susceptibility Disks/MIC Cards

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`163W00000X` — Registered Nurse Plain English: Licensed & Credentialed Registered Nurse	State: NC \| License: `380369` \| Primary: Secondary
`163WH0200X` — Registered Nurse, Home Health Plain English: CMS-Certified Home Health Care & Skilled Nursing Agency	State: NC \| License: `380369` \| Primary: Secondary
`251E00000X` — Home Health Plain English: CMS-Certified Home Health Care & Skilled Nursing Agency	State: N/A \| License: `Verified` \| Primary: Secondary
`291U00000X` — Clinical Medical Laboratory Plain English: CLIA-Certified Diagnostic Medical & Pathology Laboratory	State: NC \| License: `Verified` \| Primary: Yes (Primary)

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MARLENE KING CHISHOLM, RN (NPI #1326937137)