Provider Demographics
NPI:1750272399
Name:REAL DIAGNOSTICS, LLC
Entity type:Organization
Organization Name:REAL DIAGNOSTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CARY
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:BREESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-412-2142
Mailing Address - Street 1:200 BUSINESS CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-1230
Mailing Address - Country:US
Mailing Address - Phone:410-833-3025
Mailing Address - Fax:
Practice Address - Street 1:200 BUSINESS CENTER DR STE 200
Practice Address - Street 2:
Practice Address - City:REISTERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21136-1230
Practice Address - Country:US
Practice Address - Phone:410-833-3025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REAL DIAGNOSTICS HOLDINGS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory