| NPI | 1720294424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WELDON DAVID COUCH President 520-298-4589 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: AZ 12487) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2020-08-22 |