| NPI | 1972612828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN A JAYICH Owner/Partner 907-264-1171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: AK 33825) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AK 33825) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-08-22 |