Organization
COAL MOUNTAIN LABORATORY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICK PFEIFFER (CEO)
(502) 235-5795
Entity
Organization
Contact information
Practice address
5321 MACCORKLE AVE SE, CHARLESTON, WV 25304-2221
(502) 235-5795
Mailing address
10928 WORTHINGTON LN, PROSPECT, KY 40059-9590
(502) 235-5795
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
12/30/2020
Last updated
05/05/2021
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