| NPI | 1710234919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WANDA FAYE GOLDEN WOODS Phlebotomist /Ekg Tech 872-800-8241 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2022-07-21 |