Distinctive Diagnostics Laboratory

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

DISTINCTIVE DIAGNOSTICS LABORATORY

Practice address

1301 York Rd Ste 800
Lutherville, MD 21093-6011

Phone

(800) 410-9508

Fax

(800) 410-9508

NPI assigned

Oct 18, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Staci BeasleyNPI 1891411229

Title

Ceo/Owner

Phone

(717) 881-0575

Specialties & licenses 1

Addresses

Other names 1

• Distinctive Diagnostics Laboratory Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Staci Beasley

  • Clinical Medical Laboratory
  • Lutherville, MD
  • NPI 1891411229
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1666051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675036800000",
    "number": "1043936297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 YORK RD FL 8",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936035",
            "telephone_number": "800-410-9508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 YORK RD STE 800",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936011",
            "telephone_number": "800-410-9508",
            "fax_number": "800-410-9508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DISTINCTIVE DIAGNOSTICS LABORATORY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-18",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A",
        "authorized_official_last_name": "BEASLEY",
        "authorized_official_first_name": "STACI",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "717-881-0575",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Distinctive Diagnostics Laboratory",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Distinctive Diagnostics Laboratory",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Lindsay Dermer, MS, OTR/L
• Joanne Elizabeth Desmond, CRNP
• Michael A Dias, MD
• Francesca Dipino, FNP-C
• Direct Assisted Services of Health LLC (Dash)
• Doctors First, LLC
• Mubat Dohvoma, DPM
• Elizabeth A Donahoo, M.D.
• Michele Andrea Donehower, C.R.N.P.
• Ross C Donehower, M.D.

• Clinical Medical Laboratory in Lutherville, MD
• Providers in Lutherville, MD by specialty
• Clinical Medical Laboratory in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.