| NPI | 1851776892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DWAYNE BEASON President 225-387-1611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: LA 19D2093699) |
| Enumeration Date | 2015-07-20 |
| Last Update Date | 2015-07-20 |