| NPI | 1568877124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAVI MORISETTY Owner 469-777-4669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: TX 45D2076856) |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2016-02-17 |