51D1058092 CLIA NUMBER - WVU MEDICINE THOMAS HOSPITALS INTERNAL MEDICINE HURRICANE

Laboratory Demographics

  • CLIA Code: 51D1058092
  • Facility Name: WVU MEDICINE THOMAS HOSPITALS INTERNAL MEDICINE HURRICANE
  • Facility Address: 3006 MOUNT VERNON ROAD, SUITE 1070
    HURRICANE, WV
    ZIP 25526
  • Facility Phone: 304 201-2545
  • Facility Type: Other - PROVIDER BASE AMBULATORY
  • Facility Type: Waiver
  • Lab Director: DR. JOHN CLARK
  • NPI Number: 1609815786
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 51D1058092
LAB Type Other - PROVIDER BASE AMBULATORY
Facility Name WVU MEDICINE THOMAS HOSPITALS INTERNAL MEDICINE HURRICANE
Street 3006 MOUNT VERNON ROAD, SUITE 1070
City HURRICANE
State WV
ZIP 25526
Phone 304 201-2545
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/19/2025
Certificate Expiration Date 4/18/2027
Facility Type Other - PROVIDER BASE AMBULATORY
Lab Director DR. JOHN CLARK

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