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General NPI Number Information
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NPI Number | 1407115967
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Entity Type | Organization
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Legal Business Name | QUEST DIAGNOSTICS OF PUERTO RICO, INC
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Dates
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Enumeration Date | 05/03/2012
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | CALLE ORTEGON #107 LOCAL #5 CAPARRA GALLERY
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City | GUAYNABO
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State | PR
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Zip | 00966-0000
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Country | US
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Telephone | 787-792-3708
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Fax | 787-792-3710
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Provider Business Mailing Address
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Address Line | 107 CALLE ORTEGON, SUITE 105
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City | GUAYNABO
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State | PR
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Zip | 00966-2516
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Country | US
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Telephone |
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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 | LEAH D TIMMERMAN
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Credential |
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Telephone | 973-520-2700
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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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