West Virginia Laboratories

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

WEST VIRGINIA LABORATORIES

Practice address

1740 Union Carbide Dr BLDG 740
South Charleston, WV 25303-2732

Phone

(304) 400-6028

NPI assigned

Jul 16, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Zachery Ezra Maynard

Title

Partner, Owner

Phone

(304) 400-6028

Specialties & licenses 1

Addresses

Other names 2

• WV Labs Other name
• West Virginia Laboratories LLC Other name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1563235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581897600000",
    "number": "1346892650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4816",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253644816",
            "telephone_number": "304-400-6028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 UNION CARBIDE DR BLDG 740",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253032732",
            "telephone_number": "304-400-6028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1740 Union Carbide Dr Bldg 740",
            "address_2": "FL2 Rms 2110 2112 2114 2116",
            "address_purpose": "LOCATION",
            "city": "South Charleston",
            "state": "WV",
            "postal_code": "253032732",
            "country_code": "US",
            "telephone_number": "304-400-6028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WEST VIRGINIA LABORATORIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-16",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A",
        "authorized_official_last_name": "MAYNARD",
        "authorized_official_first_name": "ZACHERY",
        "authorized_official_middle_name": "EZRA",
        "authorized_official_title_or_position": "PARTNER, OWNER",
        "authorized_official_telephone_number": "304-400-6028"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WV Labs",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "West Virginia Laboratories LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Bridgette Wells
• Jessie Nicole Wells, CRNA
• Melissa Wells
• West Virginia Cornea & Cataract Center of Excellence
• West Virginia Dermatology and Skin Surgery Center
• West Virginia Sleep Solutions, PLLC
• West Virginia University Physician of Charleston-Valley Center
• Amber Rae West, MS, CCC-SLP
• James Elliott West
• Mary E. West, CRNA

• Clinical Medical Laboratory in South Charleston, WV
• Providers in South Charleston, WV by specialty
• Clinical Medical Laboratory in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.