| NPI | 1265646095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAYLE POORTENGA Administrator 269-948-4921 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: MI 23D1046098) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2020-08-22 |