| NPI | 1316135023 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAUL PONCE Owner 405-464-5918 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: OK 37d1069737) |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2007-10-09 |