| NPI | 1255924346 |
|---|---|
| Doing Business As | LAB TESTING FACILITY |
| Former Legal Business Name | LAB TESTING FACILITY |
| Entity Type | Organization |
| Authorized Contact | JACOB CORNELIUS PARKER Psychiatrist 601-329-1321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2021-02-19 |
| Last Update Date | 2024-05-06 |