| NPI | 1831439876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEATRICE CARROLL Owner 208-440-7009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: ID M-4116) |
| Enumeration Date | 2013-02-28 |
| Last Update Date | 2013-02-28 |