| NPI | 1710588074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAQUANDA CALDWELL Owner 757-971-1460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 261QI0500X Clinic/Center, Infusion Therapy |
| Enumeration Date | 2020-11-03 |
| Last Update Date | 2021-01-24 |