| NPI | 1972251437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA RAGER Director Revenue Cycle 844-969-0686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2022-03-14 |
| Last Update Date | 2025-03-04 |