51D1005634 CLIA NUMBER - FRUTH PHARMACY 14

Laboratory Demographics

  • CLIA Code: 51D1005634
  • Facility Name: FRUTH PHARMACY 14
  • Facility Address: 864 OAKWOOD ROAD
    CHARLESTON, WV
    ZIP 25314
  • Facility Phone: 304 343-2807
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHARLES D. MASSEY
  • NPI Number: 1073528915
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 51D1005634
LAB Type Pharmacy
Facility Name FRUTH PHARMACY 14
Street 864 OAKWOOD ROAD
City CHARLESTON
State WV
ZIP 25314
Phone 304 343-2807
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/28/2024
Certificate Expiration Date 10/27/2026
Facility Type Pharmacy
Lab Director CHARLES D. MASSEY

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