51D0690164 CLIA NUMBER - STEVEN C SOUTHERN MD

Laboratory Demographics

CLIA Number: 51D0690164

Facility Name: STEVEN C SOUTHERN MD

Facility Address:
12 COURTNEY DRIVE
CHARLESTON, WV
ZIP 25304
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Facility Phone Number: 304 925-7600

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1932162948

Taxonomy: 207RI0011X - Internal Medicine
An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system.

CLIA Record

Field Name	Field Value
CLIA Number	51D0690164
LAB Type	Physician Office
Facility Name	STEVEN C SOUTHERN MD
Street	12 COURTNEY DRIVE
City	CHARLESTON
State	WV
ZIP	25304
Phone	304 925-7600
CertificateType	3
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	PPMP

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