| NPI | 1063619922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY M WOLGAMOT Medical Director 866-987-7284 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology |
| 291U00000X Clinical Medical Laboratory | |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2025-09-08 |