51D0017142 CLIA NUMBER - CAMDEN ON GAULEY MEDICAL CENTER, INC DBA CAMDEN FAMILY HEALTH

Laboratory Demographics

CLIA Number: 51D0017142

Facility Name: CAMDEN ON GAULEY MEDICAL CENTER, INC DBA CAMDEN FAMILY HEALTH

Facility Address:
10003 WEBSTER ROAD
CAMDEN ON GAULEY, WV
ZIP 26208
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Facility Phone Number: 304 226-5725

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy

NPI Number: 1801493499

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	51D0017142
LAB Type	Federally Qualified Health Center
Facility Name	CAMDEN ON GAULEY MEDICAL CENTER, INC DBA CAMDEN FAMILY HEALTH
Street	10003 WEBSTER ROAD
City	CAMDEN ON GAULEY
State	WV
ZIP	26208
Phone	304 226-5725
CertificateType	3
CertificateEffectiveDate	7/13/2023
CertificateExpirationDate	7/12/2025
FacilityType	PPMP

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This page was last updated on: 4/23/2024