51D0977626 CLIA NUMBER - VOCA OF WV

Laboratory Demographics

CLIA Number: 51D0977626

Facility Name: VOCA OF WV

Facility Address:
811 SOUTH KANAWHA STREET
BECKLEY, WV
ZIP 25801
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Facility Phone Number: 304 252-5937

Facility Type: Intermediate Care Facility for Mentally Retarded

Certificate Type: Waiver

NPI Number: 1134283328

Taxonomy: 315P00000X - Intermediate Care Facility, Intellectual Disabilities
An intermediate care facility providing services for individuals with intellectual disabilities.

CLIA Record

Field Name	Field Value
CLIA Number	51D0977626
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	VOCA OF WV
Street	811 SOUTH KANAWHA STREET
City	BECKLEY
State	WV
ZIP	25801
Phone	304 252-5937
CertificateType	4
CertificateEffectiveDate	5/18/2023
CertificateExpirationDate	5/17/2025
FacilityType	Waiver

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