| NPI | 1891569919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PIA C SIMMONS-EVANS Owner 803-200-1557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2023-11-09 |
| Last Update Date | 2023-11-09 |