| NPI | 1376038950 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASSANDRA SMITH Business Manager 719-581-9252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: AZ 1134373) |
| Enumeration Date | 2018-06-26 |
| Last Update Date | 2018-06-26 |