| NPI | 1104972637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM A REA Member Owner 304-372-2848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: WV 808346) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2016-08-01 |