| NPI | 1417232927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN MICHAEL GARY Director 866-563-5557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: GA 0569745) |
| Enumeration Date | 2011-10-15 |
| Last Update Date | 2021-09-23 |