| NPI | 1376202689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COA FERREN MURRELL Owner/Administrator 651-615-2344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2021-12-14 |
| Last Update Date | 2023-06-23 |