| NPI | 1689520108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VENKATA SAI PAVAN KUMAR GUPTHA GURRAM Owner/Authorized Official 248-916-6381 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2026-03-06 |
| Last Update Date | 2026-04-07 |