| NPI | 1548386642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOROTHY L BLACK Managed Care Coordinator 901-725-7551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: TN 0453898) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2020-08-22 |