51D0691893 CLIA NUMBER - DEBRA C SAMS DO

Laboratory Demographics

  • CLIA Code: 51D0691893
  • Facility Name: DEBRA C SAMS DO
  • Facility Address: 122 MAPLEWOOD AVE & FAIRLEA
    RONCEVERTE, WV
    ZIP 24970
  • Facility Phone: 304 645-4406
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DEBRA C. SAMS DO
  • NPI Number: 1073700837
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 51D0691893
LAB Type Physician Office
Facility Name DEBRA C SAMS DO
Street 122 MAPLEWOOD AVE & FAIRLEA
City RONCEVERTE
State WV
ZIP 24970
Phone 304 645-4406
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director DEBRA C. SAMS DO

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