| NPI | 1013096171 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODIE B DOUGLAS Office Manager Billing Manager 304-720-7870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: WV 05800732) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2020-08-22 |