| NPI | 1225792385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEREKA JENKINS Authorized Agent 757-741-8380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2021-10-26 |
| Last Update Date | 2021-11-23 |