| NPI | 1194475657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANGAYNIKA RICHARDSON Owner 772-807-1910 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 247ZC0005X Pathology Clinical Laboratory Director, Non-physician |
| Enumeration Date | 2022-03-28 |
| Last Update Date | 2022-07-27 |