| NPI | 1154436897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID JENSEN Sole Proprietor 209-473-6555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: CA G54073) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2020-08-22 |