Organization
DISTINCTIVE DIAGNOSTICS LABORATORY
Active
Other names
Distinctive Diagnostics Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STACI BEASLEY (CEO/OWNER)
(717) 881-0575
Entity
Organization
Contact information
Practice address
1301 YORK RD STE 800, LUTHERVILLE, MD 21093-6011
(800) 410-9508
(800) 410-9508
Mailing address
1301 YORK RD FL 8, LUTHERVILLE, MD 21093-6035
(800) 410-9508
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
10/18/2022
Last updated
01/30/2023
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