| NPI | 1104839380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYED RIZVI Owner 314-737-1914 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: TX CLIA # 45D0677467) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2024-08-08 |