Healthcare Provider Details

I. General information

NPI: 1972521508
Provider Name (Legal Business Name): QUEST DIAGNOSTICS MASSACHUSETTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 05/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 BURNHAM ST
TURNERS FALLS MA
01376-1816
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 413-772-0318
  • 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 Number22D0068503
License Number StateMA

VIII. Authorized Official

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