Organization
FAMILY MEDICAL CLINIC OF JANE LEW (LAB)
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LILLIE SWISHER RN (OFFICE MANAGER)
(304) 884-7880
Entity
Organization
Contact information
Practice address
134 INDUSTRIAL PARK RD, JANE LEW, WV 26378
(304) 884-7880
(304) 884-8902
Mailing address
134 INDUSTRIAL PARK RD, PO BOX 880, JANE LEW, WV 26378
(304) 884-7880
(304) 884-8902
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6702003000
—
WV
Enumeration date
04/26/2007
Last updated
08/22/2020
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