| NPI | 1164993523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW WAFFENSMITH Director Of Operations 218-851-0213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2018-12-11 |
| Last Update Date | 2018-12-11 |