Provider Demographics
NPI:1225107303
Name:WEST VIRGINIA CYTOLOGY PLLC
Entity Type:Organization
Organization Name:WEST VIRGINIA CYTOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-720-7870
Mailing Address - Street 1:1301 DUNBAR AVENUE
Mailing Address - Street 2:
Mailing Address - City:DUNBAR
Mailing Address - State:WV
Mailing Address - Zip Code:25064-2920
Mailing Address - Country:US
Mailing Address - Phone:304-720-2293
Mailing Address - Fax:304-720-2294
Practice Address - Street 1:1301 DUNBAR AVENUE
Practice Address - Street 2:
Practice Address - City:DUNBAR
Practice Address - State:WV
Practice Address - Zip Code:25064-2920
Practice Address - Country:US
Practice Address - Phone:304-720-2293
Practice Address - Fax:304-720-2294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV028528291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV6705149000Medicaid