| NPI | 1760827141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES BROWN Dme 888-821-4667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: SC 00089823) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: OR 00089823) |
| 291U00000X Clinical Medical Laboratory (Licence: CA 00059578) | |
| Enumeration Date | 2013-04-30 |
| Last Update Date | 2014-05-16 |