| NPI | 1710028022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES ALBERT BOWLES Vice President 866-697-8378 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: PA 39D0982249) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2022-12-03 |