| NPI | 1457780371 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON DAVID PODGORNI Director Of Operations 860-207-4187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2013-11-01 |
| Last Update Date | 2013-11-01 |