| NPI | 1770246613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHALID ANSARI President 678-386-1625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 208D00000X General Practice |
| 246RP1900X Technician, Pathology, Phlebotomy | |
| Enumeration Date | 2021-10-18 |
| Last Update Date | 2023-03-30 |