| NPI | 1023551371 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STARLEEN WALLER Owner 803-832-4674 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 347C00000X Private Vehicle |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2016-11-18 |
| Last Update Date | 2016-11-18 |