| NPI | 1417353517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRK A ODOM Manager 949-637-9328 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2014-11-17 |
| Last Update Date | 2015-08-19 |