| NPI | 1255608469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG NELSON President 813-886-2364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: FL 800026361) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2011-11-17 |
| Last Update Date | 2016-06-02 |