| NPI | 1265806319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWIN KEENAN HOUSE Owner 352-796-9241 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: FL ME9793) |
| Enumeration Date | 2015-11-30 |
| Last Update Date | 2015-11-30 |