| NPI | 1336890391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATASHA CARSWELL KELLY Owner 678-365-1611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2022-01-11 |
| Last Update Date | 2022-02-03 |