51D1015228 CLIA NUMBER - CHANGE INC FAMILY MEDICAL CARE CHC

Laboratory Demographics

  • CLIA Code: 51D1015228
  • Facility Name: CHANGE INC FAMILY MEDICAL CARE CHC
  • Facility Address: 3136 WEST STREET
    WEIRTON, WV
    ZIP 26062
  • Facility Phone: 304 797-7733
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: DR. KELLI FOURNIER
  • NPI Number: 1952716433
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 51D1015228
LAB Type Federally Qualified Health Center
Facility Name CHANGE INC FAMILY MEDICAL CARE CHC
Street 3136 WEST STREET
City WEIRTON
State WV
ZIP 26062
Phone 304 797-7733
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/28/2025
Certificate Expiration Date 7/27/2027
Facility Type Federally Qualified Health Center
Lab Director DR. KELLI FOURNIER

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