49D2166998 CLIA NUMBER - APPALACHIAN CTR FOR EXCELLENCE IN HEALTHCARE

Laboratory Demographics

  • CLIA Code: 49D2166998
  • Facility Name: APPALACHIAN CTR FOR EXCELLENCE IN HEALTHCARE
  • Facility Address: 208 FRONT ST
    COEBURN, VA
    ZIP 24230
  • Facility Phone: 276 328-8850
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: TERESA TYSON
  • NPI Number: 1003380759
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 49D2166998
LAB Type Practitioner Other
Facility Name APPALACHIAN CTR FOR EXCELLENCE IN HEALTHCARE
Street 208 FRONT ST
City COEBURN
State VA
ZIP 24230
Phone 276 328-8850
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/30/2023
Certificate Expiration Date 5/29/2025
Facility Type Practitioner Other
Lab Director TERESA TYSON

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This page was last updated on: 3/20/2025