NPIMap

Organization Active NPI

Quest Diagnostics Clinical Laboratories Inc.

  • Clinical Medical Laboratory
  • Fairbanks, AK
National Provider Identifier
1932127982
Registry record updated Jul 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
02D0641234 Issued in AK
Legal business name
QUEST DIAGNOSTICS CLINICAL LABORATORIES INC.
Practice address
1405 Kellum St Ste 101
Fairbanks, AK 99701-4189
Phone
(907) 452-1658
NPI assigned
Jul 18, 2006
Organization subpart
Yes
Parent organization
QUEST DIAGNOSTICS INCORPORATEDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 30, 2026

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

Authorized official

Name
Leah D Timmerman
Title
Sr Vice President
Phone
(973) 520-2700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 02D0641234 AK Primary

Addresses

Primary practice location

1405 Kellum St Ste 101
Fairbanks, AK 99701-4189

Mailing address

4770 Regent Blvd
Irving, TX 75063-2445
Phone (973) 520-2700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040511000708 AK Part B Supplier - Independent Clinical Laboratory 3173420585 2 other NPIs on this enrollment
Practice locations: Anchorage, AK; Fairbanks, AK

Other NPIs with the same Medicare PAC ID 22

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

View all 22

Other NPIs on the same Medicare enrollment 1

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

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
02D0641234Quest Diagnostics1405 Kellum St, Ste 101, Fairbanks, AK 99701ComplianceAug 15, 2027

National Provider Directory

National Provider Directory
Tax ID family
SBCL Crestwood101 organizations share this tax ID, including this one
Part of
Quest Diagnositc Inc

Organizations with this tax ID in the same state 1

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

1919 Lathrop St
Ste 125
Fairbanks, AK 99701
Phone (907) 452-1658

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785369600000",
    "number": "1932127982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4770 REGENT BLVD",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750632445",
            "telephone_number": "973-520-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 KELLUM ST STE 101",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014189",
            "telephone_number": "907-452-1658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEST DIAGNOSTICS CLINICAL LABORATORIES INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "QUEST DIAGNOSTICS INCORPORATED",
        "enumeration_date": "2006-07-18",
        "last_updated": "2026-07-30",
        "certification_date": "2026-07-30",
        "status": "A",
        "authorized_official_last_name": "TIMMERMAN",
        "authorized_official_first_name": "LEAH",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "SR VICE PRESIDENT",
        "authorized_official_telephone_number": "973-520-2700"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "AK",
            "license": "02D0641234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2026; 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.