| NPI | 1659596161 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHANNA L LOOTENS Owner Manager 573-659-5460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: MO 26D0926409) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2020-08-22 |