Healthquest Clinical Laboratory, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

HEALTHQUEST CLINICAL LABORATORY, INC.

Practice address

5494 Arrow Hwy
Montclair, CA 91763-1604

Phone

(909) 445-9727

Fax

(909) 445-9608

NPI assigned

Dec 26, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Thomas Giancursio

Title

President

Phone

(909) 445-9727

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1514246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529452800000",
    "number": "1942716162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9807 RESEARCH DR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926184304",
            "telephone_number": "909-445-9727",
            "fax_number": "909-445-9608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5494 ARROW HWY",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917631604",
            "telephone_number": "909-445-9727",
            "fax_number": "909-445-9608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHQUEST CLINICAL LABORATORY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-26",
        "last_updated": "2018-06-20",
        "status": "A",
        "authorized_official_last_name": "GIANCURSIO",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-445-9727",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZ14399Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Reina Vanessa Henry

• Clinical Medical Laboratory in Montclair, CA
• Providers in Montclair, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; 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.