| NPI | 1083988216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALPHONSO WATERS Owner 404-376-8325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: GA 97048) |
| Enumeration Date | 2012-03-06 |
| Last Update Date | 2012-03-22 |