| NPI | 1790172807 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARED B BARTON Medical Director 307-789-8721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: WY 53D2090994) |
| Enumeration Date | 2015-04-16 |
| Last Update Date | 2015-04-16 |