| NPI | 1003802075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOM FELLOWS President 928-778-7823 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: AZ 03D0533969) |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2020-08-22 |