Provider Demographics
NPI:1780349886
Name:ABINGDON COVID TESTIG
Entity type:Organization
Organization Name:ABINGDON COVID TESTIG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-628-1148
Mailing Address - Street 1:339 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24210-2633
Mailing Address - Country:US
Mailing Address - Phone:410-628-1148
Mailing Address - Fax:
Practice Address - Street 1:339 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-2633
Practice Address - Country:US
Practice Address - Phone:410-628-1148
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE TRAVEL SHOP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA49D2236718OtherCLIA