51D1048694 CLIA NUMBER - SOUTHERN HIGHLANDS COMMUNITY MENTAL HEALTH CTR MERCER MCDOWELL WYOMING MENTAL HEALTH COUNCIL INC

Laboratory Demographics

  • CLIA Code: 51D1048694
  • Facility Name: SOUTHERN HIGHLANDS COMMUNITY MENTAL HEALTH CTR MERCER MCDOWELL WYOMING MENTAL HEALTH COUNCIL INC
  • Facility Address: 200 12TH STREET EXTENSION
    PRINCETON, WV
    ZIP 24740
  • Facility Phone: 304 425-9541
  • Facility Type: Intermediate Care Facility for Mentally Retarded
  • Facility Type: Waiver
  • Lab Director: LISA L. JONES
  • NPI Number: 1205476488
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 51D1048694
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name SOUTHERN HIGHLANDS COMMUNITY MENTAL HEALTH CTR MERCER MCDOWELL WYOMING MENTAL HEALTH COUNCIL INC
Street 200 12TH STREET EXTENSION
City PRINCETON
State WV
ZIP 24740
Phone 304 425-9541
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/8/2023
Certificate Expiration Date 12/7/2025
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director LISA L. JONES

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