| NPI | 1275307811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIANA LONG Owner 779-774-0625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 246RP1900X Technician, Pathology Phlebotomy |
| Enumeration Date | 2023-11-14 |
| Last Update Date | 2024-01-27 |