NPI | 1902971849 |
---|---|
Doing Business As | SHADY GROVE MEDICAL LABORATORY |
Entity Type | Organization |
Authorized Contact | DEANNE G PETERSEN Chief Financial Officer 301-816-5760 |
Organization Subpart ? | Yes |
Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
Enumeration Date | 2006-11-22 |
Last Update Date | 2021-05-27 |