| NPI | 1194591529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TESFU HAILU Lab Director 309-404-6583 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology |
| Enumeration Date | 2023-11-27 |
| Last Update Date | 2024-01-31 |