| NPI | 1801898986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAVI KOTHAPALLI President 813-866-5692 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: FL 800019865) |
| Enumeration Date | 2005-06-02 |
| Last Update Date | 2020-08-22 |