| NPI | 1164561528 |
|---|---|
| Other Name | SAGE MEDICAL GROUP LABORATORY |
| Entity Type | Organization |
| Authorized Contact | CHARLES D MOSES Chief Administrative Officer 307-265-8300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2020-08-22 |