51D2110088 CLIA NUMBER - MUSTANG HEALTH CENTER

Laboratory Demographics

CLIA Number: 51D2110088

Facility Name: MUSTANG HEALTH CENTER

Facility Address:
267 MIDWAY ROAD
ALUM CREEK, WV
ZIP 25003
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Facility Phone Number: 304 756-1500

Facility Type: School/Student Health Service

Certificate Type: Waiver

NPI Number: 1003274580

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	51D2110088
LAB Type	School/Student Health Service
Facility Name	MUSTANG HEALTH CENTER
Street	267 MIDWAY ROAD
City	ALUM CREEK
State	WV
ZIP	25003
Phone	304 756-1500
CertificateType	4
CertificateEffectiveDate	3/8/2024
CertificateExpirationDate	3/7/2026
FacilityType	Waiver

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