| NPI | 1114148277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE R. FREEMAN Clinical Laboratory Director 815-321-4740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: TN 3287) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2020-08-22 |