| NPI | 1134670904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT MICHEAL DAMRON General Counsel 678-640-9664 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: MI 23D0685754) |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2016-10-17 |