| NPI | 1790304285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARLY CAMPBELL Owner 877-541-8075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2021-07-15 |