51D1047113 CLIA NUMBER - HUNTINGTON TREATMENT CENTER

Laboratory Demographics

CLIA Number: 51D1047113

Facility Name: HUNTINGTON TREATMENT CENTER

Facility Address:
135 4TH AVENUE
HUNTINGTON, WV
ZIP 25701
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Facility Phone Number: 304 525-5691

Facility Type: Comp. Outpatient Rehab Facility

Certificate Type: Waiver

NPI Number: 1629299581

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	51D1047113
LAB Type	Comp. Outpatient Rehab Facility
Facility Name	HUNTINGTON TREATMENT CENTER
Street	135 4TH AVENUE
City	HUNTINGTON
State	WV
ZIP	25701
Phone	304 525-5691
CertificateType	4
CertificateEffectiveDate	10/26/2023
CertificateExpirationDate	10/25/2025
FacilityType	Waiver

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