| NPI | 1275071821 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER GALLOGLY Owner 352-379-1049 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: FL 800028308) |
| Enumeration Date | 2017-02-03 |
| Last Update Date | 2017-02-03 |