| NPI | 1740482678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENDERSON JOHNSON President 3379-484-4841 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: LA CLP.200901-PHL) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2020-08-22 |