51D0691893 CLIA NUMBER - DEBRA C SAMS DO

Laboratory Demographics

CLIA Number: 51D0691893

Facility Name: DEBRA C SAMS DO

Facility Address:
122 MAPLEWOOD AVE & FAIRLEA
RONCEVERTE, WV
ZIP 24970
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Facility Phone Number: 304 645-4406

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1073700837

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

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
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