| NPI | 1295927663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD RUSSELL LOCKE President 352-861-9078 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: FL Pending) |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2008-01-03 |