Provider Demographics
NPI:1073063939
Name:MAGNUS DIAGNOSTICS LABORATORIES, INC.
Entity Type:Organization
Organization Name:MAGNUS DIAGNOSTICS LABORATORIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCNAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-588-1025
Mailing Address - Street 1:8120 FENTON ST STE 301A
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-4796
Mailing Address - Country:US
Mailing Address - Phone:301-588-1025
Mailing Address - Fax:
Practice Address - Street 1:8120 FENTON ST STE 301A
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4796
Practice Address - Country:US
Practice Address - Phone:301-588-1025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-04
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2551291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory