| NPI | 1083588990 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANA THEDFORD Director 601-207-5085 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 247ZC0005X Pathology, Clinical Laboratory Director, Non-physician |
| Enumeration Date | 2025-10-02 |
| Last Update Date | 2025-10-02 |