| NPI | 1730852393 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KANEETAH VELMA PRIDGEN Owner 253-273-0571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine |
| Enumeration Date | 2021-07-29 |
| Last Update Date | 2021-07-29 |