| NPI | 1902343536 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN HAWKINS Owner 407-757-8747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: FL 31702004) |
| Enumeration Date | 2017-01-20 |
| Last Update Date | 2018-10-29 |