| NPI | 1750036109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA D LEWIS Owner 214-402-0282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2022-02-15 |
| Last Update Date | 2022-05-25 |