| NPI | 1013169499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL V MESA President/Owner 503-257-5568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: OR 38D1062236) |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2009-05-07 |