| NPI | 1003562943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY WILSON Director 216-324-2161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 291900000X Military Clinical Medical Laboratory |
| 291U00000X Clinical Medical Laboratory | |
| Enumeration Date | 2022-03-01 |
| Last Update Date | 2022-03-03 |