| NPI | 1588420053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDI JACKSON Owner 251-300-8331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 247ZC0005X Pathology, Clinical Laboratory Director, Non-physician |
| Enumeration Date | 2024-02-22 |
| Last Update Date | 2024-02-22 |