| NPI | 1952739633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES RAYMOND WALFORD Laboratory Manager 307-777-6053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2013-10-16 |
| Last Update Date | 2013-10-16 |