| NPI | 1891848552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE RUSSELL Credentialing Coordinator 806-354-5495 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: TX 45D1024631) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2020-08-22 |