51D1006314 CLIA NUMBER - WETZEL PRIMARY CARE

Laboratory Demographics

CLIA Number: 51D1006314

Facility Name: WETZEL PRIMARY CARE

Facility Address:
3 EAST BENJAMIN DRIVE
NEW MARTINSVILLE, WV
ZIP 26155
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Facility Phone Number: 304 455-8082

Facility Type: Rural Health Clinic

Certificate Type: Waiver

NPI Number: 1609272343

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	51D1006314
LAB Type	Rural Health Clinic
Facility Name	WETZEL PRIMARY CARE
Street	3 EAST BENJAMIN DRIVE
City	NEW MARTINSVILLE
State	WV
ZIP	26155
Phone	304 455-8082
CertificateType	4
CertificateEffectiveDate	7/1/2022
CertificateExpirationDate	6/30/2024
FacilityType	Waiver

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