| NPI | 1316350556 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD JAY BLACKBURN Owner 304-868-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: WV 1455) |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2014-06-05 |