51D1048586 CLIA NUMBER - MOUNTAIN RIDGE DIALYSIS ALLEGHANY MEDICAL SERVICE PC

Laboratory Demographics

  • CLIA Code: 51D1048586
  • Facility Name: MOUNTAIN RIDGE DIALYSIS ALLEGHANY MEDICAL SERVICE PC
  • Facility Address: 229 MERCHANTS WALK
    SUMMERSVILLE, WV
    ZIP 26651
  • Facility Phone: 304 872-9206
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DR. DIVYA RAJAN
  • NPI Number: 1649327933
  • Taxonomy: 261QE0700X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 51D1048586
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name MOUNTAIN RIDGE DIALYSIS ALLEGHANY MEDICAL SERVICE PC
Street 229 MERCHANTS WALK
City SUMMERSVILLE
State WV
ZIP 26651
Phone 304 872-9206
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 End Stage Renal Disease Dialysis Facility
Lab Director DR. DIVYA RAJAN

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