| NPI | 1164462925 |
|---|---|
| Doing Business As | ST. AGNES LAB SERVICES |
| Entity Type | Organization |
| Authorized Contact | KEITH VANDER KOLK President/CEO 667-234-2101 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2016-02-25 |