| NPI | 1821001330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWIN OLIVA SIA Director/Owner 904-824-5497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: FL 800001722) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2008-06-17 |