| NPI | 1497207559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RIZWANA THANAWALA Co Ower 386-758-6094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: FL 800027822) |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2017-03-29 |