| NPI | 1659482529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN L. WILKINSON Pathologist 601-553-6809 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: MS 25D0651894) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: MS 25D1011258) |
| 291U00000X Clinical Medical Laboratory (Licence: MS 25D0980061) | |
| 291U00000X Clinical Medical Laboratory (Licence: MS 25D0318506) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-01-20 |