Basic Information
| Provider Information | |||||||||
| NPI: | 1932301587 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | QUEST DIAGNOSTICS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2750 MONROE BLVD | ||||||||
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| City: | NORRISTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194032429 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4846767000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 74 MACK ST | ||||||||
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| City: | WINDSOR | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060952759 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8778682191 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2007 | ||||||||
| LastUpdateDate: | 11/26/2007 | ||||||||
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| AuthorizedOfficialLastName: | CARTIER | ||||||||
| AuthorizedOfficialFirstName: | G | ||||||||
| AuthorizedOfficialMiddleName: | SCOTT | ||||||||
| AuthorizedOfficialTitleorPosition: | VP OF BILLING | ||||||||
| AuthorizedOfficialTelephone: | 4846767731 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | QUEST DIAGNOSTICS INCORPORATED | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 291U00000X | CT | Y | Laboratories | Clinical Medical Laboratory |
No ID Information.