49D1090360 CLIA NUMBER - WELLMONT MEDICAL ASSOCIATES DBA BALLAD HEALTH MEDICAL ASSOCIATES

Laboratory Demographics

  • CLIA Code: 49D1090360
  • Facility Name: WELLMONT MEDICAL ASSOCIATES DBA BALLAD HEALTH MEDICAL ASSOCIATES
  • Facility Address: 127 HEALTH CARE DRIVE - SUITE 8
    PENNINGTON GAP, VA
    ZIP 24277
  • Facility Phone: 276 546-5212
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBIN M. BUTLER
  • NPI Number: 1376736637
  • Taxonomy: 273Y00000X - Rehabilitation Unit

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CLIA Record

Field Name Field Value
CLIA Number 49D1090360
LAB Type Physician Office
Facility Name WELLMONT MEDICAL ASSOCIATES DBA BALLAD HEALTH MEDICAL ASSOCIATES
Street 127 HEALTH CARE DRIVE - SUITE 8
City PENNINGTON GAP
State VA
ZIP 24277
Phone 276 546-5212
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/8/2024
Certificate Expiration Date 10/7/2026
Facility Type Physician Office
Lab Director ROBIN M. BUTLER

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This page was last updated on: 9/29/2025