MEDICARE: QUEST DIAGNOSTICS OF PUERTO RICO 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
1	291U00000X	Clinical Medical Laboratory		PR

General Provider Information

NPI Number	:	1629109137
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUEST DIAGNOSTICS OF PUERTO RICO INC

Provider Business Mailing Address
First Line	:	2750 MONROE BLVD
Second Line	:
City	:	NORRISTOWN
State	:	PA
Zip	:	19403-2429
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	214 CALLE LAS MARIAS
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00927-4213
Country	:	US
Telephone Number	:	787-751-7773
Fax Number	:

Authorized Official
Title or Position	:	VP OF BILLING
Name	:	G SCOTT CARTIER
Credential	:
Telephone Number	:	484-676-7000

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	11/21/2024

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