Organization
CENTRAL WV MEDCORP, INC
Active
Other names
CENTRAL WVMEDCORP LOC LAB
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD EDWARD PICCIRILLO M.D. (PRESIDENT)
(304) 636-7451
Entity
Organization
Contact information
Practice address
11 N LOCUST ST, BUCKHANNON, WV 26201-2231
(304) 472-4968
(304) 472-6382
Mailing address
P.O. BOX 2630, CENTRAL WV MEDCORP, INC., ELKINS, WV 26241-2630
(304) 637-3799
(304) 637-3369
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009078001
—
WV
01
—
51D0915651
CLIA NUMBERS
WV
01
—
51D1017352
CLIA NUMBER
WV
01
—
51D1061952
CLIA NUMBER
WV
01
—
51D1062732
CLIA NUMBER
WV
01
—
51D1070912
CLIA NUMBER
WV
01
—
51D1082791
CLIA NUMBER
WV
Enumeration date
02/21/2008
Last updated
05/07/2024
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