51D1018322 CLIA NUMBER - MIDDLE CROSS FAMILY MEDICAL

Laboratory Demographics

CLIA Number: 51D1018322

Facility Name: MIDDLE CROSS FAMILY MEDICAL

Facility Address:
102 RESERVATION AVENUE
BECKLEY, WV
ZIP 25801
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Facility Phone Number: 304 929-7677

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1205008711

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	51D1018322
LAB Type	Physician Office
Facility Name	MIDDLE CROSS FAMILY MEDICAL
Street	102 RESERVATION AVENUE
City	BECKLEY
State	WV
ZIP	25801
Phone	304 929-7677
CertificateType	4
CertificateEffectiveDate	10/20/2023
CertificateExpirationDate	10/19/2025
FacilityType	Waiver

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