Basic Information
| Provider Information | |||||||||
| NPI: | 1457688301 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | LABONE OF OHIO INC | ||||||||
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| OtherOrganizationName: | QUEST DIAGNOSTICS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1001 ADAMS AVE | ||||||||
| Address2: | MRGOV 2ND FLOOR | ||||||||
| City: | NORRISTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19403 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4846767000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 207 SPARKS AVE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | JEFFERSONVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 471303739 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8122834441 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/13/2009 | ||||||||
| LastUpdateDate: | 04/21/2014 | ||||||||
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| AuthorizedOfficialLastName: | LAKE | ||||||||
| AuthorizedOfficialFirstName: | J PABLO | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | VP OF REVENUE SERVICES | ||||||||
| AuthorizedOfficialTelephone: | 4846767000 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | QUEST DIAGNOSTICS INCORPORATED | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 291U00000X | Y | Laboratories | Clinical Medical Laboratory |
No ID Information.