Organization Active NPI

Quest Diagnostics Clinical Laboratories Inc

  • Clinical Medical Laboratory
  • Portland, OR
National Provider Identifier
1114963956
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
38D0672592 Issued in OR
Legal business name
QUEST DIAGNOSTICS CLINICAL LABORATORIES INC
Practice address
5220 NE 122ND Ave
Portland, OR 97230-1074
Phone
(503) 306-1000
NPI assigned
Jun 21, 2006
Last updated
Aug 9, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
QUEST DIAGNOSTICS INCORPORATEDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 9, 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 38D0672592 OR Primary

Addresses

Primary practice location

5220 NE 122ND Ave
Portland, OR 97230-1074

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 OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040226000974 OR Part B Supplier - Independent Clinical Laboratory 3173420585 10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Corvallis, OR; Portland, OR; Roseburg, OR; Salem, OR

Other NPIs on the same Medicare enrollment 5

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

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
38D0672592Quest Diagnostics5220 NE 122ND Ave, Portland, OR 97230AccreditationDec 31, 2027

National Provider Directory

National Provider Directory
Tax ID family
SBCL Crestwood101 organizations share this tax ID, including this one
Part of
Quest Diagnositc Inc

Organizations with this tax ID in the same state 3

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

5220 NE 122nd Ave
Portland, OR 97230
Phone (503) 206-1205

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": "1660003200000",
    "number": "1114963956",
    "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": "5220 NE 122ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972301074",
            "telephone_number": "503-306-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEST DIAGNOSTICS CLINICAL LABORATORIES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "QUEST DIAGNOSTICS INCORPORATED",
        "enumeration_date": "2006-06-21",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "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": "OR",
            "license": "38D0672592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.