Active NPI
Unilab Corporation
- Clinical Medical Laboratory
- Merced, CA
National Provider Identifier
1629116124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- UNILAB CORPORATION
- Practice address
- 857 W Childs Ave
Merced, CA 95341-6862 - Phone
- (209) 725-0658
- NPI assigned
- Feb 5, 2007
- Organization subpart
- Yes
- Parent organization
- UNILAB CORPORATION DBA QUEST DIAGNOSTICS
NPPES NPI Registry
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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | 05D0644027 | CA | |
| Clinical Medical Laboratory | 291U00000X | Primary |
Addresses
Primary practice location
857 W Childs Ave
Merced, CA 95341-6862
Mailing address
1201 S Collegeville Rd
Collegeville, PA 19426-2998
Phone (866) 697-8378
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LAB44027F | Other | MEDI-CAL |
Other names 1
- Quest Diagnostics
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 17
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D0644027 | Unilab Corp Dba Quest Diagnostics | Compliance | Nov 19, 2027 |
National Provider Directory
National Provider Directory- Part of
- Quest Diagnostic
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170633600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1544486400000",
"number": "1629116124",
"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": "857 W CHILDS AVE",
"city": "MERCED",
"state": "CA",
"postal_code": "953416862",
"telephone_number": "209-725-0658"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "UNILAB CORPORATION",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "UNILAB CORPORATION DBA QUEST DIAGNOSTICS",
"enumeration_date": "2007-02-05",
"last_updated": "2018-12-11",
"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": "05D0644027",
"primary": false
},
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI-CAL",
"identifier": "LAB44027F",
"state": null
}
],
"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 Merced, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2018; 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.