Healthcare Provider Details

I. General information

NPI: 1063617728
Provider Name (Legal Business Name): G&B LAB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

808 DIVISION ST
PARKERSBURG WV
26101-6049
US

IV. Provider business mailing address

1806 BOXWOOD CIR
PARKERSBURG WV
26101-9359
US

V. Phone/Fax

Practice location:
  • Phone: 304-699-4404
  • Fax: 304-699-4404
Mailing address:
  • Phone: 304-699-4404
  • Fax: 304-699-4404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MRS. GLORIA JEAN LAYNE
Title or Position: GENERAL PARTNER
Credential: PHLEBOTOMIST
Phone: 304-699-4404