Basic Information
Provider Information
NPI: 1417383183
EntityType: 2
ReplacementNPI:  
OrganizationName: QUEST DIAGNOSTICS CLINICAL LABORATORIES INC
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Mailing Information
Address1: 1001 ADAMS AVE
Address2: MRGOV 2ND FLOOR
City: NORRISTOWN
State: PA
PostalCode: 194032429
CountryCode: US
TelephoneNumber: 4846767000
FaxNumber:  
Practice Location
Address1: H44 CALLE MARGINAL
Address2: URB. SANTA RITA
City: VEGA ALTA
State: PR
PostalCode: 006926713
CountryCode: US
TelephoneNumber: 7878831271
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Other Information
ProviderEnumerationDate: 09/25/2013
LastUpdateDate: 09/25/2013
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AuthorizedOfficialLastName: CARTIER
AuthorizedOfficialFirstName: GERALD
AuthorizedOfficialMiddleName: SCOTT
AuthorizedOfficialTitleorPosition: VICE PRESIDENT
AuthorizedOfficialTelephone: 4846767000
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: QUEST DIAGNOSTICS INCORPORATED
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Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
291U00000X  Y LaboratoriesClinical Medical Laboratory 

No ID Information.


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