Healthcare Provider Details

I. General information

NPI: 1902075278
Provider Name (Legal Business Name): QUALITY DIAGNOSTICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2008
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 LUBRANO DR SUITE L-2
ANNAPOLIS MD
21401-7114
US

IV. Provider business mailing address

PO BOX 14335
BELFAST ME
04915-4036
US

V. Phone/Fax

Practice location:
  • Phone: 410-885-4411
  • Fax: 410-885-4409
Mailing address:
  • Phone: 410-885-4411
  • Fax: 410-885-4409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MR. DANNIE AHN
Title or Position: PRESIDENT
Credential:
Phone: 410-885-4411