| NPI | 1306050174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES ALBERT BOWLES Vice President 866-697-8378 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: PA 39D1065666) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2018-12-11 |