| NPI | 1356954408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDI S. YANCEY Owner 317-754-8818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 305S00000X Point of Service |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2020-08-28 |