OrganizationActive
Clendenin Health Center Lab
NPI 1407259062 · Federally Qualified Health Center (FQHC) · Clendenin, WV
Provider details
- NPI number
- 1407259062
- Entity type
- Organization
- Primary specialty
- Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jennifer Russell, Administrative Assistant(304) 734-2040
Specialties & taxonomies
Ambulatory Health Care Facilities
- Family Medicine Physician207Q00000X
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(75/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
107 Koontz Ave Ste 200
Clendenin, WV 25045-9581
Phone: (304) 734-2040
Fax: (301) 734-2047
Street-level locationGet directions
Mailing address
Po Box 70
Dawes, WV 25054-0070
Registry dates
- Enumerated
- 2014-09-26
- Last updated
- 2025-07-30
- Certified
- 2025-07-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.