| NPI | 1346915782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUKE B BERRY Owner 210-997-8630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2021-08-09 |
| Last Update Date | 2023-02-09 |