| NPI | 1104216605 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | DAVID SOBEL Owner 347-210-6969 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory | 
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory | 
| Enumeration Date | 2015-02-04 | 
| Last Update Date | 2020-12-22 |