A gold color metal and enamel device 1 1/8 inches (2.86 cm) in height overall consisting of a vertical scarlet oval, having in base a small maroon cross upon a white wedge shape supporting at center upon its apex a gold hexagonal sundial with a maroon pointer; issuant to either side from the apex of the hexagon two gold thunderbolts and standing thereon a gold lion holding horizontally in his dexter slaw a gold two-handed sword with point behind his head; below the oval on an arched gold scroll the words NEVER LATE in maroon.
Maroon and white are the colors associated with the army Medical Department and, with the cross, refer to the medical mission of the organization. The sundial is of an antique prism shape and is associated with optics, one of the areas of supply of the former MEDSOM. The sundial also refers to the motto, NEVER LATE. The gold lion on the red field is adapted from the coat of arms of the German town of Pirmasens where the center is located.
The distinctive unit insignia was originally approved for the 428th Medical Unit (Supply, Optical and Maintenance) (MEDSOM) on 2 April 1982. It was redesignated for the 428th Medical Center with the description and symbolism revised effective 16 September 1993.