51D2095052 CLIA NUMBER - COUNTRY DOCTORS COUNTRY DOCTORS FAMILY MEDICINE PROFESSIONAL CORP

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Laboratory Demographics

CLIA Number: 51D2095052

Facility Name: COUNTRY DOCTORS COUNTRY DOCTORS FAMILY MEDICINE PROFESSIONAL CORP

Facility Address:
658 BURKE ROAD
MASONTOWN, WV
ZIP 26542
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Facility Phone Number: 304 864-4362

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1497161624

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	51D2095052
LAB Type	Physician Office
Facility Name	COUNTRY DOCTORS COUNTRY DOCTORS FAMILY MEDICINE PROFESSIONAL CORP
Street	658 BURKE ROAD
City	MASONTOWN
State	WV
ZIP	26542
Phone	304 864-4362
CertificateType	3
CertificateEffectiveDate	4/29/2023
CertificateExpirationDate	4/28/2025
FacilityType	PPMP

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This page was last updated on: 4/23/2024