| NPI | 1154078541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY MONIQUE ELLSBERRY Founder/ Head Lab Technician 954-822-4722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2022-03-04 |
| Last Update Date | 2022-09-07 |