| NPI | 1164670873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY D MILLER Provider Relations Analyst 304-293-5033 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: WV 51D1013450) |
| Enumeration Date | 2008-09-05 |
| Last Update Date | 2009-06-25 |