Organization
CROSS LANES FAMILY PRACTICE, INC. (LAB)
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY C STONESTREET MD (PRESIDENT)
(304) 776-2409
Entity
Organization
Contact information
Practice address
5480 BIG TYLER RD, CROSS LANES, WV 25313-1116
(304) 776-2409
(304) 776-2023
Mailing address
5480 BIG TYLER RD, CROSS LANES, WV 25313-1116
(304) 776-2409
(304) 776-2023
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6701058000
—
WV
Enumeration date
11/01/2006
Last updated
08/22/2020
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