| NPI | 1558348151 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GWENNA J MARQUIS President 928-855-4077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: AZ 03D0534375) |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2020-08-22 |