| NPI | 1902267164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAM BROOKS Partner 309-261-7782 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: OK 37D2108849) |
| Enumeration Date | 2016-03-16 |
| Last Update Date | 2025-01-08 |