| NPI | 1679060222 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESE D SWANN Director 980-213-5501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: NC 0000000) |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2018-04-19 |