MEDICARE: STRATEGIC SCREENING & DIAGNOSTICS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246RM2200X	Medical Laboratory Technician

General Provider Information

NPI Number	:	1548948557
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STRATEGIC SCREENING & DIAGNOSTICS, LLC

Provider Business Mailing Address
First Line	:	6139 OXON HILL RD STE 1121
Second Line	:
City	:	OXON HILL
State	:	MD
Zip	:	20745-3108
Country	:	US
Telephone Number	:	240-416-9119
Fax Number	:

Provider Business Practice Location Address
First Line	:	7517 ALLENTOWN RD
Second Line	:
City	:	FORT WASHINGTON
State	:	MD
Zip	:	20744-1712
Country	:	US
Telephone Number	:	240-416-9119
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	EBONY LANE
Credential	:
Telephone Number	:	240-416-9119

Provider Enumeration Date	:	07/10/2023
Last Update Date	:	07/10/2023

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