| NPI | 1881063998 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK VINES President 662-288-8532 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: MS 25D2001454) |
| Enumeration Date | 2015-09-18 |
| Last Update Date | 2015-09-18 |