Organization
VALLEY DIAGNOSTIC LABORATORIES INC
Active
Organization
VALLEY DIAGNOSTIC LABORATORIES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIMBERLY G GOLDCAMP MT(ASCP) (OWNER/MANAGER)
(740) 446-0353
Entity
Organization
Contact information
Practice address
1504 JACKSON PIKE, GALLIPOLIS, OH 45631-1387
(740) 446-0353
(740) 441-0733
Mailing address
1504 JACKSON PIKE, P.O.BOX 33, GALLIPOLIS, OH 45631-1387
(740) 446-0353
(740) 441-0733
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
570251
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0040425000
—
WV
05
—
0489038
—
OH
05
—
37902236
—
KY
Enumeration date
10/09/2006
Last updated
12/29/2011
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