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General NPI Number Information
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NPI Number | 1164218814
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Entity Type | Organization
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Legal Business Name | BEACON BIO DX, LLC
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Dates
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Enumeration Date | 04/18/2025
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 4415 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44103-3759
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Country | US
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Telephone | 216-791-6720
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Fax |
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Provider Business Mailing Address
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Address Line | 4415 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44103-3759
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Country | US
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Telephone | 216-791-6720
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | HANI KAYYALI
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Credential | MBA
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Telephone | 216-791-6720
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number |
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License Number State |
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