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General NPI Number Information
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NPI Number | 1730122573
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Entity Type | Organization
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Legal Business Name | PIEDMONT JOINT VENTURE LABORATORY, INC.
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 10/15/2009
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Provider Practice Location Address
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Address Line | 333 W CORK ST SUITE 215
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City | WINCHESTER
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State | VA
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Zip | 22601-3870
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Country | US
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Telephone | 540-536-5500
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Fax | 540-665-4162
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Provider Business Mailing Address
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Address Line | 333 W CORK ST SUITE 215
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City | WINCHESTER
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State | VA
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Zip | 22601-3871
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Country | US
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Telephone | 540-536-5500
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Fax | 540-665-4162
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Authorized Official
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Title or Position | PRESIDENT
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Name | SUSAN DOUGHERTY
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Credential |
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Telephone | 703-222-2313
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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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