| NPI | 1417161993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDDIE LEE SMITH Owner Operator 818-901-0366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: CA 246rh0600x) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2008-05-29 |