| NPI | 1508087974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP THONG Manager 414-342-8463 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: WI 52D0390245) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2020-08-22 |