Active NPI
West Virginia Drug Testing Laboratories Inc
- Clinical Medical Laboratory
- Ronceverte, WV
National Provider Identifier
1093091936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- WEST VIRGINIA DRUG TESTING LABORATORIES INC
- Practice address
- 147 Main St W
Ronceverte, WV 24970-1259 - Phone
- (304) 647-1389
- Fax
- (304) 647-1397
- NPI assigned
- Oct 24, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jeffrey J. Williams
- Title
- Officer
- Phone
- (304) 422-8570
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Primary |
Addresses
Primary practice location
147 Main St W
Ronceverte, WV 24970-1259
Mailing address
PO Box 1385
Parkersburg, WV 26102-1385
Phone (304) 422-3915
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110413000111 | WV | Part B Supplier - Independent Clinical Laboratory | 5294919478 |
2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Parkersburg, WV; Princeton, WV; Ronceverte, WV |
Other NPIs on the same Medicare enrollment 2
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Clinical Medical Laboratory
- Parkersburg, WV
- NPI 1508169319
O20110413000111
-
- Clinical Medical Laboratory
- Princeton, WV
- NPI 1831647403
O20110413000111
National Provider Directory
National Provider Directory- Tax ID family
- West Virginia Drug Testing Laboratories Inc
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Clinical Medical Laboratory
- Parkersburg, WV
- NPI 1508169319
-
- Clinical Medical Laboratory
- Princeton, WV
- NPI 1831647403
Locations
147 Main St W
Ronceverte, WV 24970
Phone (304) 647-1389
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319414400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1601856000000",
"number": "1093091936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1385",
"city": "PARKERSBURG",
"state": "WV",
"postal_code": "261021385",
"telephone_number": "304-422-3915",
"fax_number": "304-485-4466"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "147 MAIN ST W",
"city": "RONCEVERTE",
"state": "WV",
"postal_code": "249701259",
"telephone_number": "304-647-1389",
"fax_number": "304-647-1397"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WEST VIRGINIA DRUG TESTING LABORATORIES INC",
"organizational_subpart": "NO",
"enumeration_date": "2011-10-24",
"last_updated": "2020-10-05",
"certification_date": "2020-10-05",
"status": "A",
"authorized_official_last_name": "WILLIAMS",
"authorized_official_first_name": "JEFFREY",
"authorized_official_middle_name": "J.",
"authorized_official_title_or_position": "OFFICER",
"authorized_official_telephone_number": "304-422-8570"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ronceverte, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.