NPI | 1063185015 |
---|---|
Entity Type | Organization |
Authorized Contact | IDESTA RALPH Owner 239-895-7910 |
Organization Subpart ? | No |
Primary Taxonomy | 246RP1900X Technician, Pathology, Phlebotomy |
Additional Taxonomies | 207ZB0001X Pathology, Blood Banking & Transfusion Medicine |
261Q00000X Clinic/Center | |
Enumeration Date | 2021-07-27 |
Last Update Date | 2024-11-12 |