| NPI | 1164813275 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHENICKEA GODFREY CEO 954-510-6890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2015-02-11 |
| Last Update Date | 2016-07-12 |