| NPI | 1205911187 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT BENISH President/Physician 276-236-2947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: VA 49D0232441) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2008-06-20 |