| NPI | 1558618272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY LUSTBERG Presudent 878-727-3365 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: NY 33D1092705) |
| Enumeration Date | 2012-08-13 |
| Last Update Date | 2012-08-13 |