| NPI | 1962292276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITTANY TASHAE PERRY Laboratory Director/ Owner 866-201-2345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2025-05-09 |
| Last Update Date | 2025-05-27 |