| NPI | 1174149785 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN A GODES Phlebotomy Technician 619-359-7551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246RP1900X Technician, Pathology, Phlebotomy |
| Enumeration Date | 2020-06-19 |
| Last Update Date | 2020-06-19 |