| NPI | 1740677467 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAQUELYN ALICE AGASAN Managing Director/Owner 407-369-8125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: 10D2093547) |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2021-01-13 |