| NPI | 1093494627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WHITNEY WHYTE Director 904-799-6520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 293D00000X Physiological Laboratory |
| Enumeration Date | 2023-07-12 |
| Last Update Date | 2023-07-12 |