| NPI | 1205839743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN ALAN BACCUS President/Owner 940-591-1496 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: TX 13) |
| Enumeration Date | 2005-05-28 |
| Last Update Date | 2022-07-21 |