| NPI | 1376116111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARJILLIAN WILLIAMS President 386-965-0313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246RP1900X Technician, Pathology, Phlebotomy |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2021-07-20 |
| Last Update Date | 2021-07-20 |