| NPI | 1861913576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL DIANE LOFTIN Billing Administrator 888-339-8071 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2017-07-03 |
| Last Update Date | 2023-08-15 |