| NPI | 1154326668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE LOUELLEN BOSTIC President 574-739-0004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: IN 15D0647560) |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2007-08-27 |