| NPI | 1114666120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY NGUYEN Manager 404-510-5584 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246RP1900X Technician, Pathology, Phlebotomy |
| Additional Taxonomies | 305S00000X Point of Service |
| 261QH0100X Clinic/Center, Health Services | |
| 261QR1100X Clinic/Center, Research | |
| Enumeration Date | 2022-05-31 |
| Last Update Date | 2022-05-31 |