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General NPI Number Information
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NPI Number | 1144423567
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Entity Type | Organization
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Legal Business Name | QUEST DIAGNOSTICS LLC
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 12/04/2018
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Provider Practice Location Address
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Address Line | 2 CHURCH ST STE 115
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City | NEW HAVEN
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State | CT
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Zip | 06519
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Country | US
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Telephone | 203-949-1260
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 S COLLEGEVILLE RD
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City | COLLEGEVILLE
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State | PA
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Zip | 19426-2998
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Country | US
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Telephone | 833-697-8378
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | CHARLES ALBERT BOWLES
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Credential |
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Telephone | 610-454-4122
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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 | 07D0098262
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License Number State | CT
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