51D2089419 CLIA NUMBER - BYRON H BLACK DDS PLLC

Laboratory Demographics

  • CLIA Code: 51D2089419
  • Facility Name: BYRON H BLACK DDS PLLC
  • Facility Address: 102 MEMORIAL DRIVE
    RIPLEY, WV
    ZIP 25271
  • Facility Phone: 304 514-5500
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. BYRON H. BLACK DDS
  • NPI Number: 1528041399
  • Taxonomy: 1223S0112X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 51D2089419
LAB Type Ambulatory Surgery Center
Facility Name BYRON H BLACK DDS PLLC
Street 102 MEMORIAL DRIVE
City RIPLEY
State WV
ZIP 25271
Phone 304 514-5500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/30/2024
Certificate Expiration Date 12/29/2026
Facility Type Ambulatory Surgery Center
Lab Director DR. BYRON H. BLACK DDS

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