NPIMap

Organization Active NPI

Unilab Corporation

Doing business as Quest Diagnostics

  • Clinical Medical Laboratory
  • Ventura, CA
National Provider Identifier
1265587174
Registry record updated Jun 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
05D0584787 Issued in CA
Legal business name
UNILAB CORPORATION
Doing business as
Quest Diagnostics
Practice address
2065 Sperry Ave Ste a
Ventura, CA 93003-7451
Phone
(805) 650-4858
Fax
(805) 967-8960
NPI assigned
Jan 24, 2007
Last updated
Jun 16, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
QUEST DIAGNOSTICS INCORPORATEDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 16, 2020

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) 454-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 05D0584787 CA Primary

Addresses

Primary practice location

2065 Sperry Ave Ste a
Ventura, CA 93003-7451

Mailing address

1201 S Collegeville Rd
Collegeville, PA 19426-2998
Phone (866) 697-8378

Other names 1

  • Quest Diagnostics Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040204001064 CA Part B Supplier - Independent Clinical Laboratory 7618874512 16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Arcadia, CA; Orange, CA; Redlands, CA; San Diego, CA; Ventura, CA; West Hills, CA

Other NPIs on the same Medicare enrollment 13

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

View all 13

National Provider Directory

National Provider Directory
Tax ID family
Quest Diagnostics Incorporated22 organizations share this tax ID, including this one
Part of
Corning Nichols

Other organizations with this tax ID 21

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

View all 21

Locations

5360 Hollister Ave
Ste B
Santa Barbara, CA 93111
Phone (805) 708-0823

2065 Sperry Ave
Ste A
Ventura, CA 93003
Phone (805) 650-4858

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592265600000",
    "number": "1265587174",
    "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": "2065 SPERRY AVE STE A",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930037451",
            "telephone_number": "805-650-4858",
            "fax_number": "805-967-8960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNILAB CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "QUEST DIAGNOSTICS INCORPORATED",
        "enumeration_date": "2007-01-24",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "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": "610-454-6000"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "05D0584787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quest Diagnostics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Quest Diagnostics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ventura, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; 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.

Verify at the official NPI Registry.