| NPI | 1497144729 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY L WYATT Co Owner 314-808-5083 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: MO LC001426432) |
| Enumeration Date | 2015-01-09 |
| Last Update Date | 2015-01-09 |