| NPI | 1225547276 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | CECIL BENNETT President 404-431-0482  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: GA 069-023)  | 
| Enumeration Date | 2017-09-21 | 
| Last Update Date | 2017-09-21 |