Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Clendenin Health Center Lab

Organization Family Medicine Physician · NPI 1407259062

Clendenin Health Center Lab is a Family Medicine Physician in Clendenin, West Virginia. Registered with an NPI since 2014.

In the registry since
2014
Specialties on file
2

Practice location Address checks out

107 Koontz Ave Ste 200
Clendenin, WV 25045-9581
Phone: (304) 734-2040
Fax: (301) 734-2047
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Federally Qualified Health Center (FQHC) (primary) Taxonomy 261QF0400X
Family Medicine Physician Taxonomy 207Q00000X

Record details

NPI number1407259062
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jennifer Russell — Administrative Assistant · (304) 734-2040
NPI enumeratedSeptember 26, 2014
Last updated in NPPESJuly 30, 2025
Certification dateJuly 30, 2025
Mailing addressPo Box 70, Dawes, WV 25054-0070