| NPI | 1104155357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLEY GAST VP Managed Care 502-272-5335 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: KY 100475) |
| Enumeration Date | 2009-12-17 |
| Last Update Date | 2023-01-31 |