| NPI | 1972637817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID E BERG LLC Manager 602-997-9161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: AZ 03D0700076) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2020-08-22 |