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NPI Code Detail

MEDICARE: SONORA QUEST LABORATORIES, LLC

MEDICARE: SONORA QUEST LABORATORIES, LLC
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 Laboratory03D0667324AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225125750
Entity Type Code : Organization
Provider Name (Legal Business Name) : SONORA QUEST LABORATORIES, LLC
Provider Business Mailing Address
First Line : PO BOX 67150
Second Line :
City : PHOENIX
State : AZ
Zip : 85082-7150
Country : US
Telephone Number : 602-685-5000
Fax Number : 602-685-5903
Provider Business Practice Location Address
First Line : 560 W BROWN RD STE 1011
Second Line :
City : MESA
State : AZ
Zip : 85201-3222
Country : US
Telephone Number : 480-834-3003
Fax Number :
Authorized Official
Title or Position : CHEIF FINANCIAL OFFICER
Name : MR. AL NAMEY
Credential :
Telephone Number : 602-685-5000
Provider Enumeration Date : 10/06/2006
Last Update Date : 08/31/2016

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Directions to “SONORA QUEST LABORATORIES, LLC ” Practice Location

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