Organization
UNILAB CORPORATION
Active
Parent organization
QUEST DIAGNOSTICS INCORPORATED
Other names
Quest Diagnostics
Organization subpart
Yes
Provider details
NPI number
Legal business name
QUEST DIAGNOSTICS INCORPORATED
Authorized official
CHARLES ALBERT BOWLES (VICE PRESIDENT)
(610) 454-4122
Entity
Organization
Contact information
Practice address
1550 PROFESSIONAL DR, SUITE B, PETALUMA, CA 94954-6655
(707) 782-0278
Mailing address
1201 S COLLEGEVILLE RD, COLLEGEVILLE, PA 19426-2998
(866) 697-8378
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
05D0643873
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LAB43873G
MEDI CAL
CA
Enumeration date
02/22/2007
Last updated
12/10/2018
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