| NPI | 1124993514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FNU MOHAMMED MASOOD Manager 551-344-7630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2025-10-07 |
| Last Update Date | 2026-07-22 |