| NPI | 1093033003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDI B BRAZER Director Of Operations 904-797-3115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: FL 77644) |
| Enumeration Date | 2010-05-14 |
| Last Update Date | 2011-02-28 |