| NPI | 1053132274 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAZLYN DAVIS Owner 313-425-1520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 305S00000X Point of Service |
| Enumeration Date | 2024-10-21 |
| Last Update Date | 2024-11-04 |