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NPI Code Detail

MEDICARE: QUEST DIAGNOSTICS LLC

MEDICARE: QUEST DIAGNOSTICS 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 Laboratory

General Provider Information

NPI Number : 1851982623
Entity Type Code : Organization
Provider Name (Legal Business Name) : QUEST DIAGNOSTICS LLC
Provider Business Mailing Address
First Line : 1201 S COLLEGEVILLE RD
Second Line :
City : COLLEGEVILLE
State : PA
Zip : 19426-2998
Country : US
Telephone Number : 610-454-6000
Fax Number : 610-271-4245
Provider Business Practice Location Address
First Line : 5635 W BELMONT AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60634-4384
Country : US
Telephone Number : 773-736-1830
Fax Number : 773-622-8055
Authorized Official
Title or Position : VICE PRESIDENT
Name : CHARLES ALBERT BOWLES
Credential :
Telephone Number : 610-454-6000
Provider Enumeration Date : 02/03/2021
Last Update Date : 02/03/2021

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Directions to “QUEST DIAGNOSTICS LLC ” Practice Location

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