| NPI | 1568974798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYLER PENROD Biller 305-907-4175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 246RP1900X Technician, Pathology Phlebotomy |
| Enumeration Date | 2017-10-27 |
| Last Update Date | 2020-12-18 |