| NPI | 1164607479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE HANSEN Owner 954-969-0760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: FL 291U00000X) |
| Enumeration Date | 2008-01-04 |
| Last Update Date | 2008-08-25 |