Athena Diagnostics, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

2418 Issued in MA

Legal business name

ATHENA DIAGNOSTICS, INC.

Practice address

200 Forest St
Marlborough, MA 01752

Phone

(508) 756-2886

Fax

(508) 753-5601

NPI assigned

Feb 20, 2007

Organization subpart

Yes

Parent organization

QUEST DIAGNOSTICS, INC.As reported in NPPES

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

Authorized official

Name

Mr. Karthik Kuppusamy

Title

General Manager

Phone

(508) 756-2886

Specialties & licenses 1

Addresses

Part of

Questdiagnost Ic Inc

Locations

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406764800000",
    "number": "1831234939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 FOREST ST",
            "city": "MARLBOROUGH",
            "state": "MA",
            "postal_code": "01752",
            "telephone_number": "508-756-2886",
            "fax_number": "508-753-5601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 FOREST ST",
            "city": "MARLBOROUGH",
            "state": "MA",
            "postal_code": "01752",
            "telephone_number": "508-756-2886",
            "fax_number": "508-753-5601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHENA DIAGNOSTICS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "QUEST DIAGNOSTICS, INC.",
        "enumeration_date": "2007-02-20",
        "last_updated": "2014-07-31",
        "status": "A",
        "authorized_official_last_name": "KUPPUSAMY",
        "authorized_official_first_name": "KARTHIK",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "508-756-2886",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MA",
            "license": "2418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Marlborough, MA
• Providers in Marlborough, MA by specialty
• Clinical Medical Laboratory in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.