| NPI | 1558554113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA DEL SOCORRO STRADLEY Owner/Manager 307-362-4552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: WY 53d1045034) |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2007-08-27 |