NPIMap

Organization Active NPI

Quest Diagnostics LLC Il

  • Clinical Medical Laboratory
  • Dearborn, MI
National Provider Identifier
1124541388
Registry record updated Jul 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
QUEST DIAGNOSTICS LLC IL
Practice address
3133 S Telegraph Rd Ste B
Dearborn, MI 48124-3472
Phone
(248) 321-9044
NPI assigned
Jul 19, 2017
Last updated
Jul 20, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
QUEST DIAGNOSTICS INCORPORATEDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 20, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Leah D Timmerman
Title
Vice President
Phone
(973) 520-2700

Specialties & licenses 1

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

Addresses

Primary practice location

3133 S Telegraph Rd Ste B
Dearborn, MI 48124-3472

Mailing address

4770 Regent Blvd
Irving, TX 75063-2445

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171103002103 MI Part B Supplier - Independent Clinical Laboratory 3779474986 Practice locations: Dearborn, MI

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
23D2129463Quest Diagnostics Inc - Dearborn RRL3133 S Telegraph Road, Dearborn, MI 48124ComplianceAug 23, 2027

National Provider Directory

National Provider Directory
Tax ID family
Quest Diagnostics LLC Il24 organizations share this tax ID, including this one
Part of
Corning Nichols

Other organizations with this tax ID 23

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

View all 23

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

13166 Collection Ctr Dr
Chicago, IL 60693

3133 S Telegraph Rd
Ste B
Dearborn, MI 48124
Phone (248) 321-9044

1201 S Collegeville Rd
Collegeville, PA 19426
Phone (214) 932-8018

NPI Registry JSON

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

{
    "created_epoch": "1500422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784505600000",
    "number": "1124541388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4770 REGENT BLVD",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750632445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3133 S TELEGRAPH RD STE B",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481243472",
            "telephone_number": "248-321-9044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEST DIAGNOSTICS LLC IL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "QUEST DIAGNOSTICS INCORPORATED",
        "enumeration_date": "2017-07-19",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A",
        "authorized_official_last_name": "TIMMERMAN",
        "authorized_official_first_name": "LEAH",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "973-520-2700"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2026; 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.