Active NPI
Lab One LLC
- Clinical Medical Laboratory
- Saint Charles, MO
National Provider Identifier
1245490366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- License
- 26D108935
- Legal business name
- LAB ONE LLC
- Practice address
- 1301 Boones Lick Rd Ste a
Saint Charles, MO 63301-2463 - Phone
- (636) 724-6743
- NPI assigned
- Jun 12, 2008
- Organization subpart
- Yes
- Parent organization
- QUEST DIAGNOSTICS INCORPORATED
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. J Pablo Lake
- Title
- Vice President
- Phone
- (484) 676-7000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | 26D108935 | MO | Primary |
Addresses
Primary practice location
1301 Boones Lick Rd Ste a
Saint Charles, MO 63301-2463
Mailing address
1001 Adams Ave
Mrgov 2ND Floor
Norristown, PA 19403-2429
Phone (484) 676-7000
Other names 1
- Quest Diagnostics
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070605000598 | MO | Part B Supplier - Independent Clinical Laboratory | 9931008893 |
41 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Columbia, MO; Springfield, MO; Poplar Bluff, MO; Mexico, MO; Kansas City, MO; Joplin, MO |
Other NPIs on the same Medicare enrollment 22
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Part of
- Questdiagnost Ic Inc
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213228800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1423785600000",
"number": "1245490366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 ADAMS AVE",
"address_2": "MRGOV 2ND FLOOR",
"city": "NORRISTOWN",
"state": "PA",
"postal_code": "194032429",
"telephone_number": "484-676-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 BOONES LICK RD STE A",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633012463",
"telephone_number": "636-724-6743"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LAB ONE LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "QUEST DIAGNOSTICS INCORPORATED",
"enumeration_date": "2008-06-12",
"last_updated": "2015-02-13",
"status": "A",
"authorized_official_last_name": "LAKE",
"authorized_official_first_name": "J PABLO",
"authorized_official_title_or_position": "VICE PRESIDENT",
"authorized_official_telephone_number": "484-676-7000",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": "MO",
"license": "26D108935",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Quest Diagnostics",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Saint Charles, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2015; 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.