| NPI | 1376938225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN S VICK Owner 618-628-8211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: IL 14D0960987) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2015-09-17 |