| NPI | 1528315942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIMMY D THREET Managing Member 501-519-2988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: AR BLOO120897) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: AZ 3023875) |
| Enumeration Date | 2012-08-06 |
| Last Update Date | 2012-08-06 |