| NPI | 1205272788 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANITA SMITH Director 314-942-3272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: MO 1309649) |
| Enumeration Date | 2013-05-10 |
| Last Update Date | 2021-11-09 |