| NPI | 1942479084 |
|---|---|
| Other Name | PREMIER MEDICAL GROUP LAB |
| Entity Type | Organization |
| Authorized Contact | RONALD STACKPOLE CFO 304-623-1330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: WV 51D0898849) |
| Enumeration Date | 2008-02-22 |
| Last Update Date | 2008-04-20 |