Organization
WVDHHR/OFFICE OF LABORATORY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREA MARY LABIK SC.D. (DIRECTOR)
(304) 558-3530
Entity
Organization
Contact information
Practice address
167 11TH AVE, SOUTH CHARLESTON, WV 25303-1114
(304) 558-3530
Mailing address
167 11TH AVE, SOUTH CHARLESTON, WV 25303-1114
(304) 558-3530
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0038214000
—
WV
Enumeration date
10/26/2006
Last updated
07/10/2008
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