| NPI | 1306990668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRITZ PHANORD Manager Business Office 9549-587-0606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: FL 800000197) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2020-08-22 |