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NPI Code Detail

MEDICARE: QUEST DIAGNOSTICS CLINICAL LABORATORIES INC

MEDICARE: QUEST DIAGNOSTICS CLINICAL LABORATORIES INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1291U00000XClinical Medical Laboratory

General Provider Information

NPI Number : 1194297515
Entity Type Code : Organization
Provider Name (Legal Business Name) : QUEST DIAGNOSTICS CLINICAL LABORATORIES INC
Provider Business Mailing Address
First Line : 14275 MIDWAY RD STE 400
Second Line :
City : ADDISON
State : TX
Zip : 75001-3614
Country : US
Telephone Number : 866-697-8378
Fax Number :
Provider Business Practice Location Address
First Line : 15132 E HAMPDEN AVE STE G
Second Line :
City : AURORA
State : CO
Zip : 80014-5038
Country : US
Telephone Number : 303-762-6546
Fax Number :
Authorized Official
Title or Position : VICE PRESIDENT
Name : CHARLES ALBERT BOWLES
Credential :
Telephone Number : 610-454-6000
Provider Enumeration Date : 12/24/2018
Last Update Date : 07/20/2023

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