| NPI | 1619831872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELTON MARCUS LOWAYNE HILLIARD President 945-800-8737 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2025-12-12 |
| Last Update Date | 2025-12-12 |