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NPI Code Detail

MEDICARE: SONORA QUEST LABORATORIES LLC

MEDICARE: SONORA QUEST LABORATORIES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1291U00000XClinical Medical Laboratory03D2122622AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1801331269
Entity Type Code : Organization
Provider Name (Legal Business Name) : SONORA QUEST LABORATORIES LLC
Provider Business Mailing Address
First Line : PO BOX 67150
Second Line :
City : PHOENIX
State : AZ
Zip : 85082-7150
Country : US
Telephone Number : 602-685-5000
Fax Number : 602-685-5903
Provider Business Practice Location Address
First Line : 1620 W SAINT MARYS RD
Second Line :
City : TUCSON
State : AZ
Zip : 85745-2624
Country : US
Telephone Number : 602-685-5000
Fax Number :
Authorized Official
Title or Position : PRESIDENT/CEO
Name : MR. DAVID A DEXTER
Credential : CEO
Telephone Number : 602-685-5000
Provider Enumeration Date : 12/21/2016
Last Update Date : 09/15/2022

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Directions to “SONORA QUEST LABORATORIES LLC ” Practice Location

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