51D2062939 CLIA NUMBER - MOUNTAINEER DIALYSIS

Laboratory Demographics

  • CLIA Code: 51D2062939
  • Facility Name: MOUNTAINEER DIALYSIS
  • Facility Address: 2958 ROBERT C BYRD DRIVE
    BECKLEY, WV
    ZIP 25801
  • Facility Phone: 304 252-9183
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DR. DIVYA RAJAN
  • NPI Number: 1972841625
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 51D2062939
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name MOUNTAINEER DIALYSIS
Street 2958 ROBERT C BYRD DRIVE
City BECKLEY
State WV
ZIP 25801
Phone 304 252-9183
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/24/2025
Certificate Expiration Date 7/23/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DR. DIVYA RAJAN

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