NPIMap

Organization Active NPI

Quest Diagnostics LLC

  • Clinical Medical Laboratory
  • Norwich, CT
National Provider Identifier
1083954119
Registry record updated Dec 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
QUEST DIAGNOSTICS LLC
Practice address
111 Salem Tpke
Norwich, CT 06360-7403
Phone
(860) 934-0946
NPI assigned
Feb 27, 2013
Last updated
Dec 10, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
QUEST DIAGNOSTICS INCORPORATEDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 10, 2022

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 NU Primary

Addresses

Primary practice location

111 Salem Tpke
Norwich, CT 06360-7403

Mailing address

1201 S Collegeville Rd
Collegeville, PA 19426-2998
Phone (866) 697-8378

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071227000131 CT Part B Supplier - Independent Clinical Laboratory 3072563238 14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hartford, CT; Norwich, CT; Stratford, CT; Wallingford, CT; Danbury, CT

Other NPIs on the same Medicare enrollment 14

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

View all 14

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
07D1087302Quest Diagnostics LLC111 Salem Tpke, Norwich, CT 06360ComplianceJul 21, 2027

National Provider Directory

National Provider Directory
Tax ID family
Qdi Diagnostic Medical13 organizations share this tax ID, including this one
Part of
Corning Nichols

Other organizations with this tax ID 12

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

Locations

7 N Washington St
Ste 107A
Plainville, CT 06062

NPI Registry JSON

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

{
    "created_epoch": "1361923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670630400000",
    "number": "1083954119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 S COLLEGEVILLE RD",
            "city": "COLLEGEVILLE",
            "state": "PA",
            "postal_code": "194262998",
            "telephone_number": "866-697-8378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 SALEM TPKE",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063607403",
            "telephone_number": "860-934-0946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEST DIAGNOSTICS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "QUEST DIAGNOSTICS INCORPORATED",
        "enumeration_date": "2013-02-27",
        "last_updated": "2022-12-10",
        "certification_date": "2022-12-10",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2022; 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.