| NPI | 1407153810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RON H COBURN Co Owner 859-421-9596 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: TN MD42643) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: TN MD19665) |
| Enumeration Date | 2011-02-21 |
| Last Update Date | 2012-05-24 |