| NPI | 1972658250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGIA JEAN CARMIN President 307-721-5111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: WY 53D0519764) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2020-08-22 |