| NPI | 1790845758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY ALLEN CEO, Lpn 662-745-0261 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: MS 25D1059870) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2008-03-19 |