| NPI | 1730903824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MINDY C MOREHEAD Credentialing/Billing Specialist 435-695-2077 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2024-11-14 |
| Last Update Date | 2024-11-14 |