NPI 1558557090

Blue Ridge Internal Medicine INC.

Organisation Clinical Medical Laboratory Princeton, WV

Practice location

Address: 407 12th Street Ext, Princeton, WV 24740-2300
Phone: (304) 487-0232
Fax: (304) 487-0285
Mailing address: PO Box 5065 407 12th Street Extension, Princeton, WV 24740-5065

Authorised official

Name: Jacinda Santon Smith
Title: Administrator
Phone: (304) 487-0232

Registered specialties

Clinical Medical Laboratory Primary

Laboratories Taxonomy 291U00000X Licence 1804 (WV)

Other Clinical Medical Laboratory providers in West Virginia →

Registry record

NPI: 1558557090
Entity type: Organization
NPI issued: 19 Sep 2007
Record last updated: 10 Jul 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.