| NPI | 1720409154 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY ALLEN MOSS CEO 317-850-9384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: IN 15D2070292) |
| Enumeration Date | 2014-01-03 |
| Last Update Date | 2014-04-10 |