# MATOWAKAN LABORATORIES INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053437327
- **Authorized official:** LARRY J. GODFREY MD (PRESIDENT)
- **Authorized official phone:** (304) 485-6563

## Contact information

- **Practice address:** 1824 MURDOCH AVE, PARKERSBURG, WV 26101-3230
- **Practice address phone:** (304) 485-6563
- **Practice address fax:** (304) 485-4466
- **Mailing address:** PO BOX 779, PARKERSBURG, WV 26102-0779
- **Mailing address phone:** (304) 485-6563
- **Mailing address fax:** (304) 485-4466

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZF0201X | Forensic Pathology Physician | — | WV | — |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | WV | Yes |

## Other

- **Enumeration date:** 03/21/2007
- **Last updated:** 07/21/2022