NPIMap

Organization Active NPI

Quincy Clinical Laboratory Services SC

  • Anatomic Pathology & Clinical Pathology Physician
  • Quincy, IL
National Provider Identifier
1114773272
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
QUINCY CLINICAL LABORATORY SERVICES SC
Practice address
1005 Broadway St
Quincy, IL 62301-2834
Phone
(217) 223-1200
NPI assigned
Apr 29, 2024
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. Rex Schulz, MDNPI 1780707703
Title
President
Phone
(800) 288-8325

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Practitioners 256

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 256

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20250725002506 IL Part B Supplier - Clinic/Group Practice 6800303876 Receives reassigned benefits from 5 practitioners
Practice locations: Quincy, IL

National Provider Directory

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0102X Primary

Addresses

NPPES NPI Registry

Primary practice location

1005 Broadway St
Quincy, IL 62301-2834

Mailing address

5700 Southwyck Blvd
Toledo, OH 43614-1509
Phone (800) 288-8325

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
1114773272MedicaidIL

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 19, 2025.

{
    "created_epoch": "1714348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755561600000",
    "number": "1114773272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 SOUTHWYCK BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436141509",
            "telephone_number": "800-288-8325",
            "fax_number": "419-866-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012834",
            "telephone_number": "217-223-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUINCY CLINICAL LABORATORY SERVICES SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-29",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A",
        "authorized_official_last_name": "SCHULZ",
        "authorized_official_first_name": "REX",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "800-288-8325",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114773272",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2025; 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.