| NPI | 1710641907 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITNEY BYNUM President 800-318-2900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| 305S00000X Point of Service | |
| Enumeration Date | 2021-10-25 |
| Last Update Date | 2022-01-28 |