Provider First Line Business Practice Location Address:
1900 ELECTRIC ROAD
Provider Second Line Business Practice Location Address:
LEWISGALE CLINICAL GENETICS
Provider Business Practice Location Address City Name:
SALEM
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24153-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-776-4963
Provider Business Practice Location Address Fax Number:
540-725-5018
Provider Enumeration Date:
11/17/2008