NPIMap

Organization Active NPI

Unilab Corporation

Doing business as Quest Diagnostics

  • Clinical Medical Laboratory
  • Walnut Creek, CA
National Provider Identifier
1093869455
Registry record updated Dec 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
UNILAB CORPORATION
Doing business as
Quest Diagnostics
Practice address
108 La Casa Via
Ste 105
Walnut Creek, CA 94598-3013
Phone
(925) 930-6897
NPI assigned
Jan 23, 2007
Last updated
Dec 11, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
UNILAB CORPORATION DBA QUEST DIAGNOSTICSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 11, 2018

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 05D0643815 CA
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

108 La Casa Via
Ste 105
Walnut Creek, CA 94598-3013

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
LAB43815FOtherCAMEDI CAL

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
O20031218000318 CA Part B Supplier - Independent Clinical Laboratory 7618874512 25 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sacramento, CA; San Jose, CA; Riverside, CA; Redding, CA; Highland, CA; Fresno, CA; Berkeley, 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

National Provider Directory

National Provider Directory
Part of
Quest Diagnostics Incorporated

Locations

108 La Casa Via
Ste 105
Walnut Creek, CA 94598
Phone (925) 939-9400

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544486400000",
    "number": "1093869455",
    "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": "108 LA CASA VIA",
            "address_2": "STE 105",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983013",
            "telephone_number": "925-930-6897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNILAB CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNILAB CORPORATION DBA QUEST DIAGNOSTICS",
        "enumeration_date": "2007-01-23",
        "last_updated": "2018-12-11",
        "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": "CA",
            "license": "05D0643815",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI CAL",
            "identifier": "LAB43815F",
            "state": "CA"
        }
    ],
    "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 Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.