Provider Demographics
NPI:1487609350
Name:NEODIAGNOSTIX, INC.
Entity type:Organization
Organization Name:NEODIAGNOSTIX, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:PINNOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-821-6000
Mailing Address - Street 1:910 CLOPPER RD
Mailing Address - Street 2:SUITE 240S
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-1361
Mailing Address - Country:US
Mailing Address - Phone:240-821-6001
Mailing Address - Fax:240-235-4433
Practice Address - Street 1:910 CLOPPER RD
Practice Address - Street 2:SUITE 240S
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-1361
Practice Address - Country:US
Practice Address - Phone:240-821-6000
Practice Address - Fax:240-235-4433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4186826-00Medicaid
F00038Medicare PIN
MD4186826-00Medicaid