| NPI | 1750642112 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RILEY MCDONALD Managing Director 855-878-6125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: TN 44D2040965) |
| Enumeration Date | 2012-06-01 |
| Last Update Date | 2012-06-20 |