51D0965521 CLIA NUMBER - HVI - MACCORKLE AVENUE

Laboratory Demographics

  • CLIA Code: 51D0965521
  • Facility Name: HVI - MACCORKLE AVENUE
  • Facility Address: 4315 MACCORKLE AVENUE SE
    CHARLESTON, WV
    ZIP 25304
  • Facility Phone: (304) 906-8080
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. H J. STANTON
  • NPI Number: 1528580727
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 51D0965521
LAB Type Physician Office
Facility Name HVI - MACCORKLE AVENUE
Street 4315 MACCORKLE AVENUE SE
City CHARLESTON
State WV
ZIP 25304
Phone 3049068080
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/23/2025
Certificate Expiration Date 9/22/2027
Facility Type Physician Office
Lab Director DR. H J. STANTON

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This page was last updated on: 6/29/2026