| NPI | 1639541295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN DIENST CEO 704-361-2826 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2015-10-22 |
| Last Update Date | 2016-04-19 |