| NPI | 1669879292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT DAMRON Owner 678-486-7340 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: AL 20141029000010470) |
| Enumeration Date | 2014-11-25 |
| Last Update Date | 2014-12-03 |