| NPI | 1639500648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EBONY GASTON Billing Clerk 404-755-2291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: GA LAB000323) |
| Enumeration Date | 2013-12-02 |
| Last Update Date | 2013-12-02 |