Quest Diagnostics Clinical Laboratories Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

QUEST DIAGNOSTICS CLINICAL LABORATORIES INC

Practice address

215 E Hawaii Ave Ste B-100
Nampa, ID 83686-6011

Phone

(208) 466-6484

NPI assigned

Jul 24, 2019

Organization subpart

Yes

Parent organization

QUEST DIAGNOSTICS INCORPORATEDAs reported in NPPES

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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Quest Diagnostics Clinical Laboratories Inc

  • Clinical Medical Laboratory
  • Idaho Falls, ID
  • NPI 1568912962

  O20170111002532

  Same enrollment

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

CLIA laboratory certificates

Tax ID family

Quest Diags Clin Labs Inc101 organizations share this tax ID, including this one

Part of

Questdiagnost Ic Inc

Locations

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

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668470400000",
    "number": "1831743228",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E HAWAII AVE STE B-100",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866011",
            "telephone_number": "208-466-6484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEST DIAGNOSTICS CLINICAL LABORATORIES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "QUEST DIAGNOSTICS INCORPORATED",
        "enumeration_date": "2019-07-24",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauryn Pyke, PA-C
• Michael Pysnak, D.M.D.
• Jennie Quaine, M.D.
• Audrey Quenzer, MS CCC-SLP
• Quest Counseling LLC
• Quick Recovery Chiropractic PLLC
• Nicole Quirk-Hill, CCC-SLP
• Julie Quiroz
• Myrna Fausto Quitugua
• Noell Quong-Peck

• Clinical Medical Laboratory in Nampa, ID
• Providers in Nampa, ID by specialty
• Clinical Medical Laboratory in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; 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.