Provider Demographics
NPI:1093091936
Name:WEST VIRGINIA DRUG TESTING LABORATORIES INC
Entity Type:Organization
Organization Name:WEST VIRGINIA DRUG TESTING LABORATORIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:J
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-422-8570
Mailing Address - Street 1:PO BOX 1385
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26102-1385
Mailing Address - Country:US
Mailing Address - Phone:304-422-3915
Mailing Address - Fax:304-485-4466
Practice Address - Street 1:147 MAIN ST W
Practice Address - Street 2:
Practice Address - City:RONCEVERTE
Practice Address - State:WV
Practice Address - Zip Code:24970-1259
Practice Address - Country:US
Practice Address - Phone:304-647-1389
Practice Address - Fax:304-647-1397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-24
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory