NPIMap

Organization Active NPI

Monongahela Valley Association of Health Centers, Inc.

  • Clinical Medical Laboratory
  • Shinnston, WV
National Provider Identifier
1548413982
Registry record updated Aug 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
MONONGAHELA VALLEY ASSOCIATION OF HEALTH CENTERS, INC.
Doing business as
Shinnston Clinical Lab
Practice address
1 Columbia Rd
Shinnston, WV 26431-1016
Phone
(304) 592-1040
Fax
(304) 592-5317
NPI assigned
Oct 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2011

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

Authorized official

Name
Ms. Nancy L Vandergrift
Title
President
Phone
(304) 366-0700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

1 Columbia Rd
Shinnston, WV 26431-1016

Mailing address

1322 Locust Ave
PO Box 1112
Fairmont, WV 26554-1436
Phone (304) 366-0700

Other identifiers 1

IdentifierTypeStateIssuer
51D0236497OtherWVCLIA #

Other names 1

  • Shinnston Clinical Lab Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Monongahela Val Assoc O7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1225238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313020800000",
    "number": "1548413982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1322 LOCUST AVE",
            "address_2": "PO BOX 1112",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265541436",
            "telephone_number": "304-366-0700",
            "fax_number": "304-366-9529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COLUMBIA RD",
            "city": "SHINNSTON",
            "state": "WV",
            "postal_code": "264311016",
            "telephone_number": "304-592-1040",
            "fax_number": "304-592-5317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONONGAHELA VALLEY ASSOCIATION OF HEALTH CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-29",
        "last_updated": "2011-08-11",
        "status": "A",
        "authorized_official_last_name": "VANDERGRIFT",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-366-0700",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA #",
            "identifier": "51D0236497",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shinnston Clinical Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shinnston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.