51D0960596 CLIA NUMBER - UNIVERSITY FAMILY PRACTICE

Laboratory Demographics

CLIA Code: 51D0960596
Facility Name: UNIVERSITY FAMILY PRACTICE
Facility Address: 1600 MEDICAL CENTER DRIVE
HUNTINGTON, WV
ZIP 25701
Facility Phone: 304 697-1507
Facility Type: Ancillary Testing Site in Health Care Center
Facility Type: Microscopy
Lab Director: ADRIENNE M. KINGSTON-MAYS
NPI Number: 1730183286
Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name	Field Value
CLIA Number	51D0960596
LAB Type	Ancillary Testing Site in Health Care Center
Facility Name	UNIVERSITY FAMILY PRACTICE
Street	1600 MEDICAL CENTER DRIVE
City	HUNTINGTON
State	WV
ZIP	25701
Phone	304 697-1507
Certificate Type	Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description	This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date	5/14/2025
Certificate Expiration Date	5/13/2027
Facility Type	Ancillary Testing Site in Health Care Center
Lab Director	ADRIENNE M. KINGSTON-MAYS

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