Organization
PRIME DIAGNOSTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUJWALA PUTTAGUNTA BOPPUDI MS, MBA (PRESIDENT)
(301) 459-5200
Entity
Organization
Contact information
Practice address
4300 FORBES BLVD, LANHAM, MD 20706-4314
(301) 459-5200
(301) 459-5400
Mailing address
4451 BROOKFIELD CORPORATE DR STE 205, CHANTILLY, VA 20151-1693
(703) 378-8100
(703) 378-8101
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
21-D1057808
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010400635
—
VA
05
—
039531500
—
DC
05
—
412222400
—
MD
Enumeration date
07/07/2006
Last updated
02/17/2009
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us