Provider Demographics
NPI:1164850335
Name:QUALDX, LLC
Entity Type:Organization
Organization Name:QUALDX, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TIM
Authorized Official - Middle Name:M
Authorized Official - Last Name:ZHENG
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:856-383-4540
Mailing Address - Street 1:10 EDELWEISS LN
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-2824
Mailing Address - Country:US
Mailing Address - Phone:856-383-4540
Mailing Address - Fax:888-255-4358
Practice Address - Street 1:1305 KINGS HWY N STE 2
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-1919
Practice Address - Country:US
Practice Address - Phone:856-383-4540
Practice Address - Fax:888-255-4358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-24
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09205800207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1639252182OtherNPI
PA013903OtherMEDICARE ID- UNSPECIFIED
PA013903OtherMEDICARE ID- UNSPECIFIED
PA1639252182OtherNPI