Provider Demographics
NPI:1801642764
Name:QUEST DIAGNOSTICS CLINICAL LABORATORIES INC.
Entity type:Organization
Organization Name:QUEST DIAGNOSTICS CLINICAL LABORATORIES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SVP, HEALTH PLANS
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:ALBERT
Authorized Official - Last Name:BOWLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-697-8378
Mailing Address - Street 1:14275 MIDWAY RD STE 400
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-3661
Mailing Address - Country:US
Mailing Address - Phone:866-697-8375
Mailing Address - Fax:
Practice Address - Street 1:2204 W NOB HILL BLVD STE F
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-6200
Practice Address - Country:US
Practice Address - Phone:509-746-8101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:QUEST DIAGNOSTICS INCORPORATED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory