| NPI | 1598899981 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON ROGER DUNHAM Owner 909-478-1025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: CA MMM00317M) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2008-06-26 |