| NPI | 1760570659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA RAE BILLINGS Business Manager 307-672-2095 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: 53D0662199) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: WY 53D0662199) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2010-06-09 |