| NPI | 1295190635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH RAFFERTY Owner 844-347-2643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: VA 49D2106421) |
| Enumeration Date | 2015-12-30 |
| Last Update Date | 2017-09-08 |