Healthcare Provider Details

I. General information

NPI: 1265314074
Provider Name (Legal Business Name): QUEST DIAGNOSTICS INCORPORATED MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2025
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11740 W BROAD ST STE B104
HENRICO VA
23233-1190
US

IV. Provider business mailing address

14275 MIDWAY RD STE 400
ADDISON TX
75001-3661
US

V. Phone/Fax

Practice location:
  • Phone: 410-314-1546
  • Fax:
Mailing address:
  • Phone:
  • 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