| NPI | 1063831121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS C FELLOWS President 928-713-1290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: AZ 03D2075971) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2014-04-15 |