NPIMap

Organization Active NPI

Unilab Corporation

Doing business as Quest Diagnostics

  • Clinical Medical Laboratory
  • Manteca, CA
National Provider Identifier
1497174585
Registry record updated Apr 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
UNILAB CORPORATION
Doing business as
Quest Diagnostics
Practice address
293 East Commerce Ave
Manteca, CA 95336-5061
Phone
(209) 823-2560
NPI assigned
Apr 16, 2014
Last updated
Apr 16, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
QUEST DIAGNOSTICS INCORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 16, 2014

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

Authorized official

Name
J Pablo Lake
Title
VP of Revenue Services
Phone
(484) 676-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

293 East Commerce Ave
Manteca, CA 95336-5061

Mailing address

1001 Adams Ave
Mrgov 2ND Floor
Norristown, PA 19403-2429
Phone (484) 676-7000

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
O20031218000318 CA Part B Supplier - Independent Clinical Laboratory 7618874512 25 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sacramento, CA; San Jose, CA; Riverside, CA; Redding, CA; Highland, CA; Fresno, CA; Berkeley, 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
Part of
Corning Nichols

NPI Registry JSON

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

{
    "created_epoch": "1397606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397606400000",
    "number": "1497174585",
    "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": "293 EAST COMMERCE AVE",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953365061",
            "telephone_number": "209-823-2560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNILAB CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "QUEST DIAGNOSTICS INCORPORATION",
        "enumeration_date": "2014-04-16",
        "last_updated": "2014-04-16",
        "status": "A",
        "authorized_official_last_name": "LAKE",
        "authorized_official_first_name": "J PABLO",
        "authorized_official_title_or_position": "VP OF REVENUE SERVICES",
        "authorized_official_telephone_number": "484-676-7000"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quest Diagnostics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manteca, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2014; 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.