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General NPI Number Information
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NPI Number | 1053585893
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Entity Type | Organization
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Legal Business Name | SHENANDOAH LABORATORIES, LLC
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Dates
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Enumeration Date | 04/14/2008
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Last Update Date | 04/14/2008
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Provider Practice Location Address
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Address Line | 158 CRIMSON CIR RELIANCE ROAD SUITE
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City | MARTINSBURG
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State | WV
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Zip | 25403-6611
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Country | US
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Telephone | 304-262-4757
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Fax | 304-262-4759
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Provider Business Mailing Address
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Address Line | 158 CRIMSON CIR RELIANCE ROAD SUITE
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City | MARTINSBURG
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State | WV
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Zip | 25403-6611
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Country | US
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Telephone | 304-262-4757
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Fax | 304-262-4759
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Authorized Official
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Title or Position | OWNER
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Name | KATHERINE M TWYFORD-ZIEBKE
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Credential |
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Telephone | 304-262-4757
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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