51D2133749 CLIA NUMBER - ALPHA OMEGA MEDICAL PLLC

Laboratory Demographics

  • CLIA Code: 51D2133749
  • Facility Name: ALPHA OMEGA MEDICAL PLLC
  • Facility Address: 77 HOSPITAL DR SUITE 100
    LOGAN, WV
    ZIP 25601
  • Facility Phone: 304 896-5200
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. EMAD MOUSA
  • NPI Number: 1497283352
  • Taxonomy: 207VX0000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 51D2133749
LAB Type Physician Office
Facility Name ALPHA OMEGA MEDICAL PLLC
Street 77 HOSPITAL DR SUITE 100
City LOGAN
State WV
ZIP 25601
Phone 304 896-5200
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/12/2024
Certificate Expiration Date 8/11/2026
Facility Type Physician Office
Lab Director DR. EMAD MOUSA

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