| NPI | 1801084645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA ANN KELLOM Owner/Operator 518-434-9006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: NY GA121) |
| Enumeration Date | 2007-10-05 |
| Last Update Date | 2007-10-05 |