51D1048463 CLIA NUMBER - LOGAN PEDIATRICS INC

Laboratory Demographics

  • CLIA Code: 51D1048463
  • Facility Name: LOGAN PEDIATRICS INC
  • Facility Address: 300 PROSPERITY LANE # 100
    LOGAN, WV
    ZIP 25601
  • Facility Phone: 304 831-0073
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: OKPANI M. NNACHI MD
  • NPI Number: 1396409173
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 51D1048463
LAB Type Physician Office
Facility Name LOGAN PEDIATRICS INC
Street 300 PROSPERITY LANE # 100
City LOGAN
State WV
ZIP 25601
Phone 304 831-0073
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/2/2023
Certificate Expiration Date 12/1/2025
Facility Type Physician Office
Lab Director OKPANI M. NNACHI MD

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