Healthcare Provider Details

I. General information

NPI: 1659702181
Provider Name (Legal Business Name): SONORA QUEST LABORATORIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2013
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14420 W MEEKER BLVD STE 109
SUN CITY WEST AZ
85375-5286
US

IV. Provider business mailing address

PO BOX 67150
PHOENIX AZ
85082-7150
US

V. Phone/Fax

Practice location:
  • Phone: 623-583-5072
  • Fax: 623-583-5192
Mailing address:
  • Phone: 602-685-5000
  • Fax: 602-685-5903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number03D0864619
License Number StateAZ

VIII. Authorized Official

Name: MR. AL NAMEY
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 602-685-5000