| NPI | 1114798212 |
|---|---|
| Doing Business As | GRAND LABS |
| Entity Type | Organization |
| Authorized Contact | ERIC P WALLIS Medical Director 405-605-0720 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2024-01-09 |
| Last Update Date | 2024-01-15 |