| NPI | 1679580286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND CHRISTOPHER WICKER General Manager 678-477-4402 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: GA 060-252) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2024-07-22 |