| NPI | 1356013072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VONNIQUE OWENS Owner 804-436-7603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2021-09-30 |
| Last Update Date | 2021-10-28 |