Provider Demographics
NPI:1831674084
Name:APPALACHIAN LABS OF WV LLC
Entity Type:Organization
Organization Name:APPALACHIAN LABS OF WV LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:REDDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-303-2100
Mailing Address - Street 1:708 BIGLEY AVE.
Mailing Address - Street 2:STE. A
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25302-3357
Mailing Address - Country:US
Mailing Address - Phone:304-306-2100
Mailing Address - Fax:
Practice Address - Street 1:708 BIGLEY AVE.
Practice Address - Street 2:STE. A
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25302-3357
Practice Address - Country:US
Practice Address - Phone:304-303-2100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-03
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory