| NPI | 1760481568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA BELTRAN MACLEOD Owner 304-926-4707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: MD 21D0947364) |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2010-02-17 |