| NPI | 1912283912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDA FAYE OUTLAW Secretary 910-944-0595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: NC 34D2029596) |
| Enumeration Date | 2011-10-24 |
| Last Update Date | 2012-03-16 |