| NPI | 1487659694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYLVIA LYNN FREEMAN Mgr Of Credentialing/Enrollment 508-304-7602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: MA 2465) |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2023-03-06 |