| NPI | 1649428285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL MIRANDO Owner 888-821-4667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: CA 00059578) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: OR 00089823) |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2013-04-15 |