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
1	291U00000X	Clinical Medical Laboratory

Other Identifiers

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

General Provider Information

NPI Number	:	1346884590
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	:	3700 E FORT LOWELL RD STE 130
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85716-1729
Country	:	US
Telephone Number	:	520-325-9718
Fax Number	:

Authorized Official
Title or Position	:	SR DIRECTOR OF REVENUE SERVICES
Name	:	NICHOLE KERR
Credential	:
Telephone Number	:	602-685-5427

Provider Enumeration Date	:	10/31/2019
Last Update Date	:	01/08/2026

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