Provider Demographics
NPI:1508169319
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:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-422-8570
Mailing Address - Street 1:916 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-4737
Mailing Address - Country:US
Mailing Address - Phone:304-422-8579
Mailing Address - Fax:
Practice Address - Street 1:1531 GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-0003
Practice Address - Country:US
Practice Address - Phone:304-422-8579
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-16
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory