| NPI | 1639249410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORGE AYALA JIMENEZ President 608-358-2539 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: OH 36D1061324) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: WI 52D1060986) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2020-08-22 |