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51D0234458 CLIA NUMBER - KANAWHA MEDICAL CENTER THOPSIE JAGANNATH MD

Laboratory Demographics

CLIA Number: 51D0234458

Facility Name: KANAWHA MEDICAL CENTER THOPSIE JAGANNATH MD

Facility Address:
4924 MACCORKLE AVENUE S E
CHARLESTON, WV
ZIP 25304
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Facility Phone Number: 304 925-1050

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1942247531

Taxonomy: 207R00000X - Internal Medicine
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

CLIA Record

Field Name Field Value
CLIA Number 51D0234458
LAB Type Physician Office
Facility Name KANAWHA MEDICAL CENTER THOPSIE JAGANNATH MD
Street 4924 MACCORKLE AVENUE S E
City CHARLESTON
State WV
ZIP 25304
Phone 304 925-1050
CertificateType 4
CertificateEffectiveDate 2/17/2024
CertificateExpirationDate 2/16/2026
FacilityType Waiver

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