51D2026225 CLIA NUMBER - MOUNTAIN STATE DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 51D2026225
  • Facility Name: MOUNTAIN STATE DERMATOLOGY
  • Facility Address: 165 SCOTT AVENUE SUITE 200
    MORGANTOWN, WV
    ZIP 26508
  • Facility Phone: 304 554-0400
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: JOHN G. HANCOX MD
  • NPI Number: 1457899809
  • Taxonomy: 261QP2000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 51D2026225
LAB Type Physician Office
Facility Name MOUNTAIN STATE DERMATOLOGY
Street 165 SCOTT AVENUE SUITE 200
City MORGANTOWN
State WV
ZIP 26508
Phone 304 554-0400
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 12/14/2023
Certificate Expiration Date 12/13/2025
Facility Type Physician Office
Lab Director JOHN G. HANCOX MD

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