| NPI | 1932553484 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW SEVERANCE COO 843-724-2099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: SC 42D0250434) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: SC 42D0934931) |
| 291U00000X Clinical Medical Laboratory (Licence: SC 42D0685422) | |
| Enumeration Date | 2016-04-21 |
| Last Update Date | 2016-04-21 |