| NPI | 1750668703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKI THEISEN General Manager 734-929-6305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: MI 23D20178) |
| Enumeration Date | 2011-11-04 |
| Last Update Date | 2013-01-18 |