| NPI | 1356445969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELVIN J VAN BOVEN Authorized Official 918-582-0001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2021-08-11 |