Organization
BERKELEY FAMILY MEDICINA ASSOCIATES LAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUMMER D MOORE (OFFICE MANAGER)
(304) 263-8911
Entity
Organization
Contact information
Practice address
101 MARCLEY DR, MARTINSBURG, WV 25401-2977
(304) 263-8911
(304) 263-9098
Mailing address
101 MARCLEY DR, MARTINSBURG, WV 25401-2977
(304) 263-8911
(304) 263-9098
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
51D0234567
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011451001
—
WV
01
—
001709694
MTN STATE GROUP #
WV
01
—
C10269
RAILROAD GROUP #
WV
Enumeration date
12/13/2006
Last updated
05/15/2008
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