Organization
MAYS LANDING DIAGNOSTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES D BEVELL JR. (OWNER)
(772) 210-4338
Entity
Organization
Contact information
Practice address
823 SE OSCEOLA ST STE 4, STUART, FL 34994-2431
(772) 210-4338
Mailing address
PO BOX 721, MONTGOMERYVILLE, PA 18936-0721
(772) 210-4338
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10D2164233
CLIA
FL
01
—
29448
COLA
FL
Enumeration date
04/10/2019
Last updated
04/12/2019
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