51D0662831 CLIA NUMBER - CRANBERRY MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 51D0662831
  • Facility Name: CRANBERRY MEDICAL CLINIC
  • Facility Address: 603 B WEST STATE AVE
    TERRA ALTA, WV
    ZIP 26764
  • Facility Phone: 304 789-2457
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROGER A. LEWIS MD
  • NPI Number: 1508981291
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 51D0662831
LAB Type Physician Office
Facility Name CRANBERRY MEDICAL CLINIC
Street 603 B WEST STATE AVE
City TERRA ALTA
State WV
ZIP 26764
Phone 304 789-2457
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/15/2025
Certificate Expiration Date 9/14/2027
Facility Type Physician Office
Lab Director ROGER A. LEWIS MD

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