| NPI | 1083031439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM R KENNEDY Sole Proprietor 612-625-1431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: MN 15228) |
| Enumeration Date | 2014-03-24 |
| Last Update Date | 2014-03-24 |