51D2116162 CLIA NUMBER - MARSHALL DENTISTRY AND ORAL MAXILLOFACIAL SURGERY

Laboratory Demographics

  • CLIA Code: 51D2116162
  • Facility Name: MARSHALL DENTISTRY AND ORAL MAXILLOFACIAL SURGERY
  • Facility Address: 1616 13TH AVENUE STE 200
    HUNTINGTON, WV
    ZIP 25701
  • Facility Phone: 304 691-1247
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. RAJ K. KHANNA
  • NPI Number: 1396254538
  • Taxonomy: 235Z00000X - Speech-Language Pathologist

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CLIA Record

Field Name Field Value
CLIA Number 51D2116162
LAB Type Physician Office
Facility Name MARSHALL DENTISTRY AND ORAL MAXILLOFACIAL SURGERY
Street 1616 13TH AVENUE STE 200
City HUNTINGTON
State WV
ZIP 25701
Phone 304 691-1247
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/20/2024
Certificate Expiration Date 7/19/2026
Facility Type Physician Office
Lab Director DR. RAJ K. KHANNA

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