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Organization

KANAWHA SURGICENTER

Active
Other names
Kanawha Surgicenter Lab
Organization subpart
No

Provider details

NPI number
Authorized official
GORLI HARISH MD (DIRECTOR)
(304) 925-6390
Entity
Organization

Contact information

Practice address
4803 MACCORKLE AVE SE, CHARLESTON, WV 25304-1948
(304) 925-6390
(304) 925-7931
Mailing address
4803 MACCORKLE AVE SE, CHARLESTON, WV 25304-1948
(304) 925-6390
(304) 925-7931

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
10453
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0009812000
WV
05
0038025000
WV
Enumeration date
09/20/2006
Last updated
08/22/2020
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