| NPI | 1730230947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WESLEY C BURKHARDT Director, Owner, President 228-872-3680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2011-10-06 |