| NPI | 1417283623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYLVIA LYNN FREEMAN Mgr Of Credentialing/Enrollment 508-304-7602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2009-10-22 |
| Last Update Date | 2023-11-03 |