| NPI | 1902145626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE GOAD Billing Manager 571-281-3553 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: VA 20122295) |
| Enumeration Date | 2013-02-01 |
| Last Update Date | 2013-02-01 |