Quest Diagnostics LLC Il

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

QUEST DIAGNOSTICS LLC IL

Practice address

23030 State Route 73 Ste a
West Portsmouth, OH 45663-8861

Phone

(740) 858-1063

NPI assigned

Jun 23, 2020

Organization subpart

Yes

Parent organization

QUEST DIAGNOSTICS INCORPORATEDAs reported in NPPES

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) 454-6000

Specialties & licenses 1

Addresses

Part of

Questdiagnost Ic Inc

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

{
    "created_epoch": "1592870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592870400000",
    "number": "1053937219",
    "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": "750013676",
            "telephone_number": "214-932-8018",
            "fax_number": "610-271-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23030 STATE ROUTE 73 STE A",
            "city": "WEST PORTSMOUTH",
            "state": "OH",
            "postal_code": "456638861",
            "telephone_number": "740-858-1063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEST DIAGNOSTICS LLC IL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "QUEST DIAGNOSTICS INCORPORATED",
        "enumeration_date": "2020-06-23",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "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": "610-454-6000"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy Penix
• Keri Piatt
• Misty Brooke Pierce
• Amy Renee Pollitt
• Lynda Pressley, CDCA
• Paul Richard Ramey II, DO
• Kayla Riggs, RN
• David Albert Robinson
• Roger Hemming Contractor, LLC
• Dennis Rogers

• Clinical Medical Laboratory in West Portsmouth, OH
• Providers in West Portsmouth, OH by specialty
• Clinical Medical Laboratory in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.