NPIMap

Organization Active NPI

Unilab Corporation

  • Clinical Medical Laboratory
  • San Diego, CA
National Provider Identifier
1023054863
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
05D0707476 Issued in CA
Legal business name
UNILAB CORPORATION
Practice address
9245 Activity Rd
Ste 109 & Ste 110
San Diego, CA 92126-4441
Phone
(800) 848-4225
NPI assigned
Jun 21, 2006
Organization subpart
Yes
Parent organization
QUEST DIAGNOSTICS INCORPORATEDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Charles Albert Bowles
Title
Vice President
Phone
(610) 454-4122

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 05D0707476 CA Primary

Addresses

Primary practice location

9245 Activity Rd
Ste 109 & Ste 110
San Diego, CA 92126-4441

Mailing address

14275 Midway Rd Ste 400
Addison, TX 75001-3614
Phone (774) 843-3205

Other names 1

  • Quest Diagnostics Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040204001064 CA Part B Supplier - Independent Clinical Laboratory 7618874512 16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Arcadia, CA; Orange, CA; Redlands, CA; San Diego, CA; Ventura, CA; West Hills, CA

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0707476Unilab Corporation Dba Quest Diagnostics9245 Activity Road #109, San Diego, CA 92126AccreditationFeb 8, 2027

National Provider Directory

National Provider Directory
Tax ID family
Quest Diagnostic22 organizations share this tax ID, including this one
Part of
Questdiagnost Ic Inc

Other organizations with this tax ID 21

Organizations that report the same tax identification number in the National Provider Directory.

View all 21

Locations

9245 Activity Rd
Ste 109
San Diego, CA 92126
Phone (800) 848-4225

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692230400000",
    "number": "1023054863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14275 MIDWAY RD STE 400",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750013614",
            "telephone_number": "774-843-3205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9245 ACTIVITY RD",
            "address_2": "STE 109 & STE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264441",
            "telephone_number": "800-848-4225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNILAB CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "QUEST DIAGNOSTICS INCORPORATED",
        "enumeration_date": "2006-06-21",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A",
        "authorized_official_last_name": "BOWLES",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "ALBERT",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "610-454-4122"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "05D0707476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quest Diagnostics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Quest Diagnostics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.