| NPI | 1184245458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOYA T SPROUL Owner 904-335-8331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 246RM2200X Technician, Pathology, Medical Laboratory |
| 246RP1900X Technician, Pathology, Phlebotomy | |
| Enumeration Date | 2020-04-28 |
| Last Update Date | 2021-06-16 |