51D2091410 CLIA NUMBER - AIR EVAC LIFETEAM #121

Laboratory Demographics

  • CLIA Code: 51D2091410
  • Facility Name: AIR EVAC LIFETEAM #121
  • Facility Address: 163 CARE DRIVE
    MOUNT HOPE, WV
    ZIP 25880
  • Facility Phone: 304 252-1033
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: LAURA FORREN
  • NPI Number: 1710385315
  • Taxonomy: 3416A0800X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 51D2091410
LAB Type Ambulance
Facility Name AIR EVAC LIFETEAM #121
Street 163 CARE DRIVE
City MOUNT HOPE
State WV
ZIP 25880
Phone 304 252-1033
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/12/2025
Certificate Expiration Date 2/11/2027
Facility Type Ambulance
Lab Director LAURA FORREN

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