| NPI | 1326621939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLOTTE L JOHNSON Managing Officer 972-972-0698 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2021-05-02 |
| Last Update Date | 2022-01-18 |