| NPI | 1316832629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONIECE DORSEY Owner 803-236-5333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| 293D00000X Physiological Laboratory | |
| Enumeration Date | 2025-06-09 |
| Last Update Date | 2025-06-09 |