| NPI | 1083490437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND CHRISTOPHER WICKER Vice President 678-477-4402 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology |
| Enumeration Date | 2023-09-01 |
| Last Update Date | 2023-09-01 |