| NPI | 1932159118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG D LARISCY President 863-683-7171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: FL 800000683) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2016-02-02 |