51D2109315 CLIA NUMBER - FRUTH PHARMACY AT PRESTERA CENTER # 104

Laboratory Demographics

  • CLIA Code: 51D2109315
  • Facility Name: FRUTH PHARMACY AT PRESTERA CENTER # 104
  • Facility Address: 511 MORRIS STREET
    CHARLESTON, WV
    ZIP 25301
  • Facility Phone: 304 341-0257
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHARLES D. MASSEY
  • NPI Number: 1629078118
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 51D2109315
LAB Type Pharmacy
Facility Name FRUTH PHARMACY AT PRESTERA CENTER # 104
Street 511 MORRIS STREET
City CHARLESTON
State WV
ZIP 25301
Phone 304 341-0257
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/23/2024
Certificate Expiration Date 2/22/2026
Facility Type Pharmacy
Lab Director CHARLES D. MASSEY

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