| NPI | 1518028521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUMMER D MOORE Office Manager 304-263-8911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: WV 51D0234567) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2008-05-15 |