| NPI | 1932239431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYLVIA LYNN FREEMAN Mgr Of Credentialing/Enrollment 508-304-7602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: CT CL-0484) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2016-06-08 |