| NPI | 1831789270 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA LYLE Credential / Billing Specialist 667-212-3626 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2021-01-20 |
| Last Update Date | 2021-01-20 |