| NPI | 1912393729 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON WALLACE Partner 720-548-4343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: CO 20151019747) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2019-06-18 |