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General NPI Number Information
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NPI Number | 1114681632
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Entity Type | Organization
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Legal Business Name | QUALITY MEDICAL TESTING LLC
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Dates
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Enumeration Date | 10/30/2021
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 11817 CANON BLVD STE 304
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-4516
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Country | US
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Telephone | 757-932-7720
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Fax | 757-257-0244
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Provider Business Mailing Address
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Address Line | 11817 CANON BLVD STE 304
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-4516
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Country | US
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Telephone | 757-932-7720
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Fax | 757-257-0244
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Authorized Official
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Title or Position | CEO
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Name | JESSICA GRAY
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Credential |
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Telephone | 757-932-7720
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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