Provider Demographics
NPI:1811443302
Name:REALITY CHECK DRUG TESTING
Entity type:Organization
Organization Name:REALITY CHECK DRUG TESTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LEO
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:MUNCY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-466-2675
Mailing Address - Street 1:550 N EISENHOWER DR
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-3109
Mailing Address - Country:US
Mailing Address - Phone:304-466-2675
Mailing Address - Fax:304-254-9099
Practice Address - Street 1:550 N EISENHOWER DR
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-3109
Practice Address - Country:US
Practice Address - Phone:304-466-2675
Practice Address - Fax:304-254-9099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-25
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory