Healthcare Provider Details

I. General information

NPI: 1649882028
Provider Name (Legal Business Name): QUEST DIAGNOSTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2020
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7777 ST RT 23, STE A
PIKETON OH
45661
US

IV. Provider business mailing address

14275 MIDWAY RD STE 400
ADDISON TX
75001-3614
US

V. Phone/Fax

Practice location:
  • Phone: 740-289-3508
  • Fax:
Mailing address:
  • Phone: 214-932-8018
  • Fax: 610-271-4245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical 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