Organization
DIVERSE DIAGNOSTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RODENY BLOCKSTON (LAB MANAGER)
(443) 888-2733
Entity
Organization
Contact information
Practice address
3706 CRONDALL LN STE 101A, OWINGS MILLS, MD 21117-2234
(410) 807-8579
Mailing address
3706 CRONDALL LN STE 101A, OWINGS MILLS, MD 21117-2234
(443) 888-2733
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
07/14/2020
Last updated
06/17/2022
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