| NPI | 1730513888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENAYE KHARRL Billing Specialist Level 3 208-429-1445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2013-08-26 |
| Last Update Date | 2013-08-26 |