Provider Demographics
NPI:1194062448
Name:QUEST DIAGNOSTICS MASSACHUSETTS LLC
Entity type:Organization
Organization Name:QUEST DIAGNOSTICS MASSACHUSETTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BETZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-216-0670
Mailing Address - Street 1:14275 MIDWAY RD STE 400
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-3661
Mailing Address - Country:US
Mailing Address - Phone:774-843-3062
Mailing Address - Fax:610-271-4245
Practice Address - Street 1:200 FOREST ST
Practice Address - Street 2:3RD FLOOR,SUITE A
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-3023
Practice Address - Country:US
Practice Address - Phone:774-369-3900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-07
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory