| NPI | 1225194574 |
|---|---|
| Doing Business As | SANFORD BROADWAY CLINIC- LABORATORY |
| Entity Type | Organization |
| Authorized Contact | MARTHA K LECLERC Vice President 701-234-6248 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: ND DEA#:35D0655616) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2023-07-31 |