| NPI | 1356645295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG KEITH NELSON President 813-886-2616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: FL 800026057) |
| Enumeration Date | 2011-01-07 |
| Last Update Date | 2011-06-15 |