| NPI | 1891191953 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT DAMRON Owner 678-486-7340 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: OK 3512478144) |
| Enumeration Date | 2014-11-17 |
| Last Update Date | 2014-11-17 |