51D0688358 CLIA NUMBER - UNION CARBIDE CORPORATION MEDICAL DEPARTMENT

Laboratory Demographics

CLIA Number: 51D0688358

Facility Name: UNION CARBIDE CORPORATION MEDICAL DEPARTMENT

Facility Address:
437 MACCORKLE AVENUE SOUTHWEST
SOUTH CHARLESTON, WV
ZIP 25303
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Facility Phone Number: 304 747-2525

Facility Type: Industrial

Certificate Type: Waiver

NPI Number: 1598955676

Taxonomy: 261QX0100X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	51D0688358
LAB Type	Industrial
Facility Name	UNION CARBIDE CORPORATION MEDICAL DEPARTMENT
Street	437 MACCORKLE AVENUE SOUTHWEST
City	SOUTH CHARLESTON
State	WV
ZIP	25303
Phone	304 747-2525
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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