NPIMap

Organization Active NPI

Quest Diagnostics LLC

  • Clinical Medical Laboratory
  • Bangor, ME
National Provider Identifier
1659061190
Registry record updated May 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
QUEST DIAGNOSTICS LLC
Doing business as
Quest Diagnostics LLC
Practice address
1 Cumberland PL
Bangor, ME 04401-5083
Phone
(207) 447-7648
NPI assigned
May 9, 2023
Last updated
May 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2023

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
(866) 697-8378

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

1 Cumberland PL
Bangor, ME 04401-5083

Mailing address

14275 Midway Rd Ste 400
Addison, TX 75001-3614
Phone (774) 843-3062

Other names 1

  • Quest Diagnostics LLC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231115001150 ME Part B Supplier - Independent Clinical Laboratory 9234114075 Practice locations: Bangor, ME

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
20D2277679Quest Diagnostics LLC1 Cumberland PL, Bangor, ME 04401ComplianceDec 18, 2027

National Provider Directory

National Provider Directory
Tax ID family
Quest Diagnostics Incorporated18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

1 Cumberland Pl
Bangor, ME 04401
Phone (207) 447-7648

NPI Registry JSON

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

{
    "created_epoch": "1683590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683590400000",
    "number": "1659061190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14275 MIDWAY RD STE 400",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750013614",
            "telephone_number": "774-843-3062",
            "fax_number": "610-271-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CUMBERLAND PL",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015083",
            "telephone_number": "207-447-7648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEST DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-09",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "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": "866-697-8378"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quest Diagnostics LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bangor, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2023; 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.