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General NPI Number Information
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NPI Number | 1851536460
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Entity Type | Organization
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Legal Business Name | CLEVELAND CLINIC MEDICAL SERVICES, INC.
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Dates
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Enumeration Date | 12/10/2008
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Last Update Date | 01/10/2012
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Provider Practice Location Address
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Address Line | 415 MORRIS ST SUITE 403
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City | CHARLESTON
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State | WV
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Zip | 25301-1842
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Country | US
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Telephone | 304-388-7929
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Fax | 304-388-7939
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Provider Business Mailing Address
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Address Line | 10524 EUCLID AVE MAIL CODE C100
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City | CLEVELAND
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State | OH
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Zip | 44106-2205
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Country | US
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Telephone | 216-445-1561
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Fax | 216-444-8261
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. MEDHAT Z. ASKAR
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Credential | MD, PHD
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Telephone | 216-444-5918
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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 | 51D0991289
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License Number State | WV
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