| NPI | 1871244509 |
|---|---|
| Other Name | N/A |
| Entity Type | Organization |
| Authorized Contact | LAVON LASHANDA SMITH Owner 856-571-3312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2022-01-13 |
| Last Update Date | 2022-03-14 |