| NPI | 1861719668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY B CADY CEO 760-803-8635 |
| Organization Subpart ? | No |
| Primary Taxonomy | 293D00000X Physiological Laboratory (Licence: CA ER345A) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: CA ER345A) |
| Enumeration Date | 2010-05-03 |
| Last Update Date | 2013-09-23 |