| NPI | 1710409305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA THOMAS Director 410-824-8149 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: MD 21D2112279) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2017-07-14 |
| Last Update Date | 2022-07-21 |