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NPI 1386654663ActiveOrganization· Physiological Laboratory· Ellicott City, MD

Physiological Laboratory in Ellicott City, Maryland, registered in NPPES in August 2006. The authorized official on file is Laurie A. Davis, Administrator. Enrolled in Medicare as part b supplier - independent diagnostic testing facility (idtf).

Overview

NPI1386654663
StatusActive
Entity typeOrganization
NPI issuedAug 9, 2006
Last updated in NPPESFeb 27, 2012

Specialties and licenses

TaxonomyCodeLicenseState
Physiological Laboratory Primary293D00000X—MD

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Oct 9, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 10, 2026No match—
New York OMIG · Nov 10, 2026No match—
Ohio Medicaid · Nov 10, 2026No match—
Pennsylvania Medicheck · Nov 10, 2026No match—
Washington HCA · Nov 10, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Enrolled Part B Supplier - Independent Diagnostic Testing Facility (Idtf) (MD)

Medicare sources and data years