Organization
UHA JEFFERSON MAT CTR LAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY D MILLER (PROVIDER RELATIONS ANALYST)
(304) 293-5033
Entity
Organization
Contact information
Practice address
207 S PRESTON ST, RANSON, WV 25438-1628
(304) 293-5033
(304) 293-6963
Mailing address
PO BOX 897, MORGANTOWN, WV 26507-0897
(304) 293-5033
(304) 293-6963
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
6705075000
WV
Other
Enumeration date
05/21/2007
Last updated
08/22/2020
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