| NPI | 1356181515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANSENIO CLARK Owner 334-669-8574 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2024-05-27 |
| Last Update Date | 2024-06-13 |