51D1042228 CLIA NUMBER - BLACK DIAMOND PHARMACY LLC

Laboratory Demographics

  • CLIA Code: 51D1042228
  • Facility Name: BLACK DIAMOND PHARMACY LLC
  • Facility Address: MAIN STREET
    NORTHFORK, WV
    ZIP 24868
  • Facility Phone: 304 862-2105
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DAVID H. DUNSON RPH MBA
  • NPI Number: 1558444026
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 51D1042228
LAB Type Pharmacy
Facility Name BLACK DIAMOND PHARMACY LLC
Street MAIN STREET
City NORTHFORK
State WV
ZIP 24868
Phone 304 862-2105
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/22/2025
Certificate Expiration Date 6/21/2027
Facility Type Pharmacy
Lab Director DAVID H. DUNSON RPH MBA

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