51D2079342 CLIA NUMBER - PETERSBURG CBOC

Laboratory Demographics

  • CLIA Code: 51D2079342
  • Facility Name: PETERSBURG CBOC
  • Facility Address: 15 GRANT STREET
    PETERSBURG, WV
    ZIP 26847
  • Facility Phone: 304 257-5817
  • Facility Type: Community Clinic
  • Facility Type: Accreditation
  • Lab Director: VASAVI KALIKI
  • NPI Number: 1538347943
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 51D2079342
LAB Type Community Clinic
Facility Name PETERSBURG CBOC
Street 15 GRANT STREET
City PETERSBURG
State WV
ZIP 26847
Phone 304 257-5817
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 6/15/2014
Certificate Expiration Date 5/22/2026
Facility Type Community Clinic
Lab Director VASAVI KALIKI

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