| NPI | 1629160858 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERNANDO JIMENEZ Owner 304-264-1212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WV 10129) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2014-09-16 |