| NPI | 1700255841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRENDRA DESAI Physician 904-302-3553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: FL ME 93419) |
| Enumeration Date | 2015-09-18 |
| Last Update Date | 2015-09-18 |