| NPI | 1740477561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL WELTON HEPPNER President 386-755-4734 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: FL HHC7803) |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2007-09-25 |