| NPI | 1649636275 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE LYNN CAMILLO Owner 618-344-2920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: MO 26D2014386) |
| Enumeration Date | 2016-01-12 |
| Last Update Date | 2016-01-12 |