| NPI | 1811416191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET RADFORD Compliance Officer 904-705-7776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: OH 36D2134952) |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2017-09-18 |