| NPI | 1033602776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNE GILBERT Owner 337-595-5116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 261QH0100X Clinic/Center Health Service |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2024-07-18 |