| NPI | 1477272409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEISHA N. FORD-JENRETTE Principal 678-469-4212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 207RI0001X Internal Medicine Clinical & Laboratory Immunology |
| Enumeration Date | 2022-08-23 |
| Last Update Date | 2022-08-26 |