| NPI | 1104466994 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRENT MCCALLSON AO 702-287-7375 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology |
| Enumeration Date | 2020-01-09 |
| Last Update Date | 2023-09-26 |