| NPI | 1407806144 |
|---|---|
| Former Legal Business Name | SOUTHERN DIAGNOSTIC LABORATORIES, LLC |
| Entity Type | Organization |
| Authorized Contact | WILSON R CONDE Vice President 973-520-2911 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: AL 01D1015388) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: AL 12279) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2017-04-24 |