51D1044087 CLIA NUMBER - SUMMERSVILLE GROUP HOME

Laboratory Demographics

  • CLIA Code: 51D1044087
  • Facility Name: SUMMERSVILLE GROUP HOME
  • Facility Address: 509 DUFFY STREET
    SUMMERSVILLE, WV
    ZIP 26651
  • Facility Phone: 304 645-6226
  • Facility Type: Intermediate Care Facility for Mentally Retarded
  • Facility Type: Waiver
  • Lab Director: CATHY REDDEN
  • NPI Number: 1134464290
  • Taxonomy: 208000000X - Pediatrics

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 51D1044087
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name SUMMERSVILLE GROUP HOME
Street 509 DUFFY STREET
City SUMMERSVILLE
State WV
ZIP 26651
Phone 304 645-6226
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/10/2025
Certificate Expiration Date 8/9/2027
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director CATHY REDDEN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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