| NPI | 1629814611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA N WHITE Lab Director 222-293-9885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 251E00000X Home Health |
| Enumeration Date | 2024-07-08 |
| Last Update Date | 2024-07-08 |