| NPI | 1932353042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY B. PERUSKI Credentialing Coordinator 770-301-0231 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: GA 038-005) |
| Enumeration Date | 2008-11-17 |
| Last Update Date | 2008-11-17 |