51D0687206 CLIA NUMBER - JOHN MANCHIN SR HEALTH CARE CENTER

Laboratory Demographics

  • CLIA Code: 51D0687206
  • Facility Name: JOHN MANCHIN SR HEALTH CARE CENTER
  • Facility Address: 401 GUFFEY STREET
    FAIRMONT, WV
    ZIP 26554
  • Facility Phone: 304 363-2500
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: JAMES S. NAMSUPAK MD
  • NPI Number: 1689849804
  • Taxonomy: 3336C0002X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 51D0687206
LAB Type Community Clinic
Facility Name JOHN MANCHIN SR HEALTH CARE CENTER
Street 401 GUFFEY STREET
City FAIRMONT
State WV
ZIP 26554
Phone 304 363-2500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/2/2025
Certificate Expiration Date 4/1/2027
Facility Type Community Clinic
Lab Director JAMES S. NAMSUPAK MD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 6/4/2025