| NPI | 1790169027 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA JOHNSON Owner 561-503-9906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: FL 80027597) |
| Enumeration Date | 2015-07-16 |
| Last Update Date | 2015-07-16 |