| NPI | 1861097511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZACHARY ADAMS COO 631-384-6339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2020-12-01 |
| Last Update Date | 2021-01-15 |