| NPI | 1821367061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY HAYES Owner 817-226-6900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: TX 45D2015778) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2011-12-16 |
| Last Update Date | 2016-03-30 |