51D2056906 CLIA NUMBER - SOUTHERN WEST VIRGINIA HEALTH SYSTEM

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Laboratory Demographics

CLIA Number: 51D2056906

Facility Name: SOUTHERN WEST VIRGINIA HEALTH SYSTEM

Facility Address:
1563 SAND PLANT ROAD
CHARLESTON, WV
ZIP 25309
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Facility Phone Number: 304 756-1500

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy

NPI Number: 1457610594

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	51D2056906
LAB Type	Federally Qualified Health Center
Facility Name	SOUTHERN WEST VIRGINIA HEALTH SYSTEM
Street	1563 SAND PLANT ROAD
City	CHARLESTON
State	WV
ZIP	25309
Phone	304 756-1500
CertificateType	3
CertificateEffectiveDate	4/5/2023
CertificateExpirationDate	4/4/2025
FacilityType	PPMP

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This page was last updated on: 4/23/2024