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 |