| NPI | 1417604091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY LEWIS Owner 901-949-6228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2022-03-03 |
| Last Update Date | 2022-03-07 |