| NPI | 1487789343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDELL L WELLS Director 208-678-8899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: ID PO33) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2008-12-09 |