| NPI | 1407466253 |
|---|---|
| Doing Business As | TESTSOURCE LAB |
| Entity Type | Organization |
| Authorized Contact | RICK VAN LAAN President 269-216-3668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2020-08-06 |
| Last Update Date | 2020-08-06 |