| NPI | 1073270773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TREVOR HARDER Lab Director 855-955-5428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine Infectious Disease |
| Additional Taxonomies | 261QH0100X Clinic/Center Health Service |
| 3336C0003X Pharmacy Community/Retail Pharmacy | |
| Enumeration Date | 2021-11-17 |
| Last Update Date | 2025-05-09 |