Lifequest Diagnostic, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

LIFEQUEST DIAGNOSTIC, INC.

Practice address

720 N Valley St
Ste F
Anaheim, CA 92801-3830

Phone

(714) 290-5440

Fax

(855) 844-9188

NPI assigned

Apr 3, 2023

Organization subpart

No

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

Authorized official

Name

Mrs. Roda L Paderna

Title

Chief Executive Officer Ceo

Phone

(714) 290-5440

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680480000000",
    "number": "1265137905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3595 INLAND EMPIRE BLVD BLDG 4",
            "address_2": "SUITE 200",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917645920",
            "telephone_number": "909-770-4403",
            "fax_number": "855-844-9188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 N VALLEY ST",
            "address_2": "STE F",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928013830",
            "telephone_number": "714-290-5440",
            "fax_number": "855-844-9188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEQUEST DIAGNOSTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-03",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A",
        "authorized_official_last_name": "PADERNA",
        "authorized_official_first_name": "RODA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER CEO",
        "authorized_official_telephone_number": "714-290-5440",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.