| NPI | 1881780765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA CLEMENTS JEFFORDS Laboratory Manager 1803-435-4316 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2020-08-22 |