Healthcare Provider Details
I. General information
NPI: 1760221592
Provider Name (Legal Business Name): QUEST DIAGNOSTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/21/2024
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
851 MIDDLE ST STE 2100
FALL RIVER MA
02721-1781
US
IV. Provider business mailing address
14275 MIDWAY RD STE 400
ADDISON TX
75001-3661
US
V. Phone/Fax
- Phone: 508-961-0831
- Fax:
- Phone: 774-843-3062
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 291U00000X |
| Taxonomy | Clinical Medical Laboratory |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LEAH
D
TIMMERMAN
Title or Position: SR. VICE PRESIDENT
Credential:
Phone: 973-520-2700