| NPI | 1609410042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL DAVID CORMIER Owner 480-306-7227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 207KI0005X Allergy & Immunology, Clinical & Laboratory Immunology |
| Enumeration Date | 2019-10-29 |
| Last Update Date | 2021-07-09 |