51D0720059 CLIA NUMBER - MOUNTAIN STATE MEDICAL SPECIALTIES, PLLC

Laboratory Demographics

  • CLIA Code: 51D0720059
  • Facility Name: MOUNTAIN STATE MEDICAL SPECIALTIES, PLLC
  • Facility Address: 120 MEDICAL PARK DRIVE SUITE 200
    BRIDGEPORT, WV
    ZIP 26330
  • Facility Phone: 304 624-7200
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: CHARLES B. FRANZ
  • NPI Number: 1437643061
  • Taxonomy: 261QP2000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 51D0720059
LAB Type Physician Office
Facility Name MOUNTAIN STATE MEDICAL SPECIALTIES, PLLC
Street 120 MEDICAL PARK DRIVE SUITE 200
City BRIDGEPORT
State WV
ZIP 26330
Phone 304 624-7200
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 2/6/2024
Certificate Expiration Date 2/5/2026
Facility Type Physician Office
Lab Director CHARLES B. FRANZ

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