Organization
APPALACHIAN FAMILY MEDICINE LAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SEAN C DICRISTOFARO MD (OWNER)
(304) 757-7788
Entity
Organization
Contact information
Practice address
104 STATION PLACE WAY, HURRICANE, WV 25526-8747
(304) 757-7788
(304) 201-1140
Mailing address
104 STATION PLACE WAY, HURRICANE, WV 25526-8747
(304) 757-7788
(304) 201-1140
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5630468003
—
WV
Enumeration date
07/30/2007
Last updated
07/30/2007
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