| NPI | 1811441751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARON A DOMENICO COO 267-525-2470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: CT CL-0764) |
| Enumeration Date | 2016-08-09 |
| Last Update Date | 2020-02-20 |