| NPI | 1801982947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD WOLF Practice Administrator 307-670-0740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: WY 53D0520056) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2015-01-27 |