| NPI | 1639577091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN FLUITT Owner/Operator 318-410-9900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: LA 19D2087059) |
| Enumeration Date | 2014-12-16 |
| Last Update Date | 2017-06-14 |