| NPI | 1265892830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN A CAMILLO Owner 314-200-6450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: MO 26D2045157) |
| Enumeration Date | 2016-02-25 |
| Last Update Date | 2016-02-25 |