Quest Diagnostics Clinical Laboratories Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

38D0667969 Issued in OR

Legal business name

QUEST DIAGNOSTICS CLINICAL LABORATORIES INC

Practice address

2410 NW Edenbower Blvd
Roseburg, OR 97471-8830

Phone

(541) 957-2600

NPI assigned

Jul 18, 2006

Organization subpart

Yes

Parent organization

QUEST DIAGNOSTICS INCORPORATEDAs reported in NPPES

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

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Other NPIs on the same Medicare enrollment 5

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

• Quest Diagnostics Clinical Laboratories Inc

  • Clinical Medical Laboratory
  • Portland, OR
  • NPI 1114963956

  O20040226000974

  Same enrollment
• Quest Diagnostics Clinical Laboratories Inc

  • Clinical Medical Laboratory
  • Eugene, OR
  • NPI 1568980555

  O20040226000974

  Same enrollment
• Quest Diagnostics Clinical Laboratories Inc

  • Clinical Medical Laboratory
  • Salem, OR
  • NPI 1598094302

  O20040226000974

  Same enrollment
• Quest Diagnostics Clinical Laboratories Inc

  • Clinical Medical Laboratory
  • Corvallis, OR
  • NPI 1659888097

  O20040226000974

  Same enrollment
• Quest Diagnostics Clinical Laboratories Inc.

  • Clinical Medical Laboratory
  • Salem, OR
  • NPI 1679592208

  O20040226000974

  Same enrollment

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

CLIA laboratory certificates

Tax ID family

SBCL Crestwood101 organizations share this tax ID, including this one

Part of

Quest Diagnositc Inc

Organizations with this tax ID in the same state 3

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Quest Diagnostics Clinical Laboratories Inc

  • Clinical Medical Laboratory
  • Portland, OR
  • NPI 1114963956
  NPD tax ID
• Quest Diagnostics Clinical Laboratories Inc

  • Clinical Medical Laboratory
  • Corvallis, OR
  • NPI 1659888097
  NPD tax ID
• Quest Diagnostics Clinical Laboratories Inc.

  • Clinical Medical Laboratory
  • Salem, OR
  • NPI 1679592208
  NPD tax ID

Locations

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664841600000",
    "number": "1285652800",
    "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": "2410 NW EDENBOWER BLVD",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974718830",
            "telephone_number": "541-957-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEST DIAGNOSTICS CLINICAL LABORATORIES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "QUEST DIAGNOSTICS INCORPORATED",
        "enumeration_date": "2006-07-18",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "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": "OR",
            "license": "38D0667969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosa Maira Pugh-Hunter
• Laurence Everett Putman I, D.D.S.
• Sarah Pytalski
• Robert Quamme, BS, CADC I
• Tamara Lee Quamme, CADC I
• Lisa Quillin, LPN
• Corina Gabriela Rachita, MD
• Mircea S. Rachita, MD
• Deirdrah Renee Racine, QMHP
• Michael Racine, MD

• Clinical Medical Laboratory in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Clinical Medical Laboratory in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; 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.