Provider Demographics
NPI:1710633409
Name:LAB QUEST LLC
Entity Type:Organization
Organization Name:LAB QUEST LLC
Other - Org Name:LABQUEST LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-261-7782
Mailing Address - Street 1:13301 N MERIDIAN AVE STE 704E
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-9369
Mailing Address - Country:US
Mailing Address - Phone:405-445-6001
Mailing Address - Fax:
Practice Address - Street 1:1003 US 83 FRONTAGE RD.
Practice Address - Street 2:
Practice Address - City:ALAMO
Practice Address - State:TX
Practice Address - Zip Code:78516
Practice Address - Country:US
Practice Address - Phone:405-445-6001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-22
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory