NPIMap

Organization Active NPI

Sonora Quest Laboratories LLC

  • Clinical Medical Laboratory
  • Tucson, AZ
National Provider Identifier
1205923612
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
03D0669882 Issued in AZ
Legal business name
SONORA QUEST LABORATORIES LLC
Practice address
630 N Alvernon Way Ste 120
Tucson, AZ 85711-1895
Phone
(520) 322-8264
NPI assigned
Oct 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

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

Authorized official

Name
Mr. David A Dexter, CEO
Title
President/Ceo
Phone
(602) 685-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 03D0669882 AZ Primary

Addresses

Primary practice location

630 N Alvernon Way Ste 120
Tucson, AZ 85711-1895

Mailing address

PO Box 67150
Phoenix, AZ 85082-7150
Phone (602) 685-5000

Other identifiers 1

IdentifierTypeStateIssuer
452152MedicaidAZ

Other names 1

  • Sonora Quest Laboratories of Tucson Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040714001218 AZ Part B Supplier - Independent Clinical Laboratory 4688653629 23 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Peoria, AZ; Phoenix, AZ; Tempe, AZ; Tucson, AZ; Yuma, AZ

Other NPIs on the same Medicare enrollment 22

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

View all 22

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
03D0669882Sonora Quest Laboratories LLC630 N Alvernon Way Ste 120, Tucson, AZ 85711AccreditationApr 28, 2028

National Provider Directory

National Provider Directory
Tax ID family
Sonora Quest Laboratories17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

Locations

630 N Alvernon Way
Ste 120
Tucson, AZ 85711
Phone (520) 322-8264

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686096000000",
    "number": "1205923612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67150",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850827150",
            "telephone_number": "602-685-5000",
            "fax_number": "602-685-5903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 N ALVERNON WAY STE 120",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857111895",
            "telephone_number": "520-322-8264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SONORA QUEST LABORATORIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A",
        "authorized_official_last_name": "DEXTER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "602-685-5000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "AZ",
            "license": "03D0669882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "452152",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sonora Quest Laboratories of Tucson",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Sonora Quest Laboratories of Tucson",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; 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.