Provider Demographics
NPI:1114681632
Name:QUALITY MEDICAL TESTING LLC
Entity Type:Organization
Organization Name:QUALITY MEDICAL TESTING LLC
Other - Org Name:QUALITY LAB SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-932-7720
Mailing Address - Street 1:11817 CANON BLVD STE 304
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4516
Mailing Address - Country:US
Mailing Address - Phone:757-932-7720
Mailing Address - Fax:757-257-0244
Practice Address - Street 1:11817 CANON BLVD STE 304
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4516
Practice Address - Country:US
Practice Address - Phone:757-932-7720
Practice Address - Fax:757-257-0244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-30
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory