Provider Demographics
NPI:1043238090
Name:UNILAB CORPORATION
Entity Type:Organization
Organization Name:UNILAB CORPORATION
Other - Org Name:DBA QUEST DIAGNOSTICS INCORPORATED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP NATIONAL BILLING
Authorized Official - Prefix:
Authorized Official - First Name:G.
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:CARTIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-676-7731
Mailing Address - Street 1:2750 MONROE BLVD
Mailing Address - Street 2:MR200
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19403-2429
Mailing Address - Country:US
Mailing Address - Phone:484-676-7331
Mailing Address - Fax:
Practice Address - Street 1:1045 S ATLANTIC AVE
Practice Address - Street 2:STE 507
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813-3414
Practice Address - Country:US
Practice Address - Phone:562-628-9031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
05D090142BMedicare ID - Type Unspecified