| NPI | 1275921595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CALVIN EDWARD BUSBY Owner 469-407-2811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 246RP1900X Technician, Pathology, Phlebotomy |
| Enumeration Date | 2015-01-08 |
| Last Update Date | 2015-01-08 |