Provider Demographics
NPI:1407519887
Name:BIOQUEST DIAGNOSTICS INC
Entity Type:Organization
Organization Name:BIOQUEST DIAGNOSTICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DIAMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:CALLOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-656-9261
Mailing Address - Street 1:4500 BOWLING BLVD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-5147
Mailing Address - Country:US
Mailing Address - Phone:502-909-3024
Mailing Address - Fax:502-909-3024
Practice Address - Street 1:4500 BOWLING BLVD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-5147
Practice Address - Country:US
Practice Address - Phone:502-909-3024
Practice Address - Fax:502-909-3024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-21
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory