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51D0961757 CLIA NUMBER - MOUNTAIN STATE MEDICAL ASSOCIATES

Laboratory Demographics

CLIA Number: 51D0961757

Facility Name: MOUNTAIN STATE MEDICAL ASSOCIATES

Facility Address:
NORTH GATE BUSINESS PARK 300 KENTON DRIVE SUITE 100
CHARLESTON, WV
ZIP 25311
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Facility Phone Number: 304 346-5533

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1447349238

Taxonomy: 207R00000X - Internal Medicine
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

CLIA Record

Field Name Field Value
CLIA Number 51D0961757
LAB Type Physician Office
Facility Name MOUNTAIN STATE MEDICAL ASSOCIATES
Street NORTH GATE BUSINESS PARK 300 KENTON DRIVE SUITE 100
City CHARLESTON
State WV
ZIP 25311
Phone 304 346-5533
CertificateType 4
CertificateEffectiveDate 6/16/2023
CertificateExpirationDate 6/15/2025
FacilityType Waiver

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