| NPI | 1700080710 |
|---|---|
| Other Name | FACIAL SURGERY CENTER I LAB |
| Entity Type | Organization |
| Authorized Contact | JEFFERY H. GOODE President 304-388-7783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2007-11-15 |