| NPI | 1538652805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKSON BENEFIELD President 314-649-9508 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: MO 26D0953866) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2021-07-30 |