Provider Demographics
NPI:1427604453
Name:QUATER DIAGNOSTIC LABS LLC
Entity Type:Organization
Organization Name:QUATER DIAGNOSTIC LABS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BING
Authorized Official - Middle Name:
Authorized Official - Last Name:SU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-986-2771
Mailing Address - Street 1:4247 MAPLE RD
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-1039
Mailing Address - Country:US
Mailing Address - Phone:716-428-3581
Mailing Address - Fax:716-568-8265
Practice Address - Street 1:4247 MAPLE RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-1039
Practice Address - Country:US
Practice Address - Phone:716-428-3581
Practice Address - Fax:716-568-8265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-15
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory