Active NPI
Quest Diagnostics Clinical Laboratories Inc
- Clinical Medical Laboratory
- Jackson, MS
National Provider Identifier
1285955062
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- QUEST DIAGNOSTICS CLINICAL LABORATORIES INC
- Practice address
- 3502 W Northside Dr
Jackson, MS 39213-4454 - Phone
- (601) 982-1625
- NPI assigned
- Jun 16, 2010
- 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
- Gerald Scott Cartier
- Title
- Government Enrollment Analyst
- Phone
- (484) 676-7000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Primary |
Addresses
Primary practice location
3502 W Northside Dr
Jackson, MS 39213-4454
Mailing address
1001 Adams Ave Mrgov
2ND Floor
Norristown, PA 19403-2429
Phone (484) 676-7000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071204000046 | MS | Part B Supplier - Independent Clinical Laboratory | 3173420585 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Meridian, MS |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Clinical Medical Laboratory
- Meridian, MS
- NPI 1376756114
O20071204000046
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": "1276646400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1350000000000",
"number": "1285955062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 ADAMS AVE MRGOV",
"address_2": "2ND FLOOR",
"city": "NORRISTOWN",
"state": "PA",
"postal_code": "194032429",
"telephone_number": "484-676-7000",
"fax_number": "484-676-5309"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3502 W NORTHSIDE DR",
"city": "JACKSON",
"state": "MS",
"postal_code": "392134454",
"telephone_number": "601-982-1625"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "QUEST DIAGNOSTICS CLINICAL LABORATORIES INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "QUEST DIAGNOSTICS INCORPORATED",
"enumeration_date": "2010-06-16",
"last_updated": "2012-10-12",
"status": "A",
"authorized_official_last_name": "CARTIER",
"authorized_official_first_name": "GERALD",
"authorized_official_middle_name": "SCOTT",
"authorized_official_title_or_position": "GOVERNMENT ENROLLMENT ANALYST",
"authorized_official_telephone_number": "484-676-7000"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2012; 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.