| NPI | 1033797311 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACIE BLUE Administrator 864-979-0846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 261Q00000X |
| 291U00000X Clinical Medical Laboratory | |
| Enumeration Date | 2021-03-30 |
| Last Update Date | 2021-06-17 |