| NPI | 1801642764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES ALBERT BOWLES SVP, Health Plans 866-697-8378 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2024-04-30 |
| Last Update Date | 2024-04-30 |