51D1048581 CLIA NUMBER - MARTINSBURG CORRECTIONAL CENTER WEXFORD HEALTH SOURCES

Laboratory Demographics

  • CLIA Code: 51D1048581
  • Facility Name: MARTINSBURG CORRECTIONAL CENTER WEXFORD HEALTH SOURCES
  • Facility Address: 38 GRAPEVINE ROAD
    MARTINSBURG, WV
    ZIP 25401
  • Facility Phone: 304 267-0156
  • Facility Type: Prison
  • Facility Type: Waiver
  • Lab Director: BRANDON INGRAM
  • NPI Number: 1316596794
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 51D1048581
LAB Type Prison
Facility Name MARTINSBURG CORRECTIONAL CENTER WEXFORD HEALTH SOURCES
Street 38 GRAPEVINE ROAD
City MARTINSBURG
State WV
ZIP 25401
Phone 304 267-0156
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/6/2023
Certificate Expiration Date 12/5/2025
Facility Type Prison
Lab Director BRANDON INGRAM

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