| NPI | 1932362555 |
|---|---|
| Other Name | INDEPENDENT CLINICAL LABORATORY |
| Entity Type | Organization |
| Authorized Contact | JEFFREY L SUSI CEO 772-567-4311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: FL 4029) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2008-07-03 |