51D2079897 CLIA NUMBER - WVU MEDICINE THOMAS HOSPITAL PEDIATRICS

Laboratory Demographics

  • CLIA Code: 51D2079897
  • Facility Name: WVU MEDICINE THOMAS HOSPITAL PEDIATRICS
  • Facility Address: 4501 MACCORKLE AVE 2ND FLOOR
    SOUTH CHARLESTON, WV
    ZIP 25309
  • Facility Phone: 304 767-7970
  • Facility Type: Other - PROVIDER BASE AMB CLINIC
  • Facility Type: Waiver
  • Lab Director: DR. GILBERT GOLIATH
  • NPI Number: 1437155991
  • Taxonomy: 208000000X - Pediatrics

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 51D2079897
LAB Type Other - PROVIDER BASE AMB CLINIC
Facility Name WVU MEDICINE THOMAS HOSPITAL PEDIATRICS
Street 4501 MACCORKLE AVE 2ND FLOOR
City SOUTH CHARLESTON
State WV
ZIP 25309
Phone 304 767-7970
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/26/2024
Certificate Expiration Date 6/25/2026
Facility Type Other - PROVIDER BASE AMB CLINIC
Lab Director DR. GILBERT GOLIATH

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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