| NPI | 1558116251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOLANDA ANTERNETT GRIMES Owner 904-803-8358 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse |
| 246RP1900X Technician, Pathology, Phlebotomy | |
| Enumeration Date | 2024-04-17 |
| Last Update Date | 2024-04-17 |