| NPI | 1790841781 |
|---|---|
| Doing Business As | STATE HOSPITAL SOUTH LABORATORY |
| Entity Type | Organization |
| Authorized Contact | RALPH DUANE HECKARD Medical Director 208-785-8429 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2020-08-22 |