| NPI | 1356638829 |
|---|---|
| Other Name | HERITAGE LABORATORY MESQUITE |
| Entity Type | Organization |
| Authorized Contact | RAYMOND EUGENE DAVIS CEO 972-698-0586 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2011-08-01 |