Healthcare Provider Details

I. General information

NPI: 1386783637
Provider Name (Legal Business Name): QUEST DIAGNOSTICS INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 10/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11411 S BROOKSHIRE AVE STE 203
DOWNEY CA
90241-5003
US

IV. Provider business mailing address

1001 ADAMS AVE MRGOV 2ND FLOOR
NORRISTOWN PA
19403-2429
US

V. Phone/Fax

Practice location:
  • Phone: 562-923-5474
  • Fax:
Mailing address:
  • Phone: 484-676-7000
  • Fax: 484-676-5309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number05D0547573
License Number StateCA

VIII. Authorized Official

Name: GERALD SCOTT CARTIER
Title or Position: VP OF REVENU SERVICES
Credential:
Phone: 484-676-7000