| NPI | 1205169414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONSTANCE JEAN CHASTAIN President 954-977-7959 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: FL 800025540) |
| Enumeration Date | 2009-09-08 |
| Last Update Date | 2022-07-21 |