| NPI | 1063881837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEDRO BOJORQUEZ President 619-255-7725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: CA 2015041531) |
| Additional Taxonomies | 171W00000X Contractor (Licence: CA 2015041531) |
| Enumeration Date | 2015-09-22 |
| Last Update Date | 2016-10-13 |