| NPI | 1902693914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE PITTMAN Owner 601-596-2795 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 291900000X Military Clinical Medical Laboratory |
| Enumeration Date | 2025-04-22 |
| Last Update Date | 2025-04-22 |