| NPI | 1740240597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY ALAN GOLDFOGEL President 360-734-9033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: WA MD 23314) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2020-08-22 |