| NPI | 1760782122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAM M MICHAELS Incorporator 704-660-3322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: NC 34D2015092) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: NC 34D2015092) |
| Enumeration Date | 2010-11-01 |
| Last Update Date | 2010-11-16 |