| NPI | 1437162302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEAH FONTENOT Billing Credentialing Supervisor 409-813-2228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: TX 45D0999705) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2020-01-03 |