51D2149969 CLIA NUMBER - GRANT MEMORIAL HOSPITAL BENSENHAVER MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 51D2149969
  • Facility Name: GRANT MEMORIAL HOSPITAL BENSENHAVER MEDICAL CLINIC
  • Facility Address: 100 HOSPITAL DRIVE
    PETERSBURG, WV
    ZIP 26847
  • Facility Phone: 304 257-1944
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. DEWEY F. BENSENHAVER
  • NPI Number: 1801592126
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 51D2149969
LAB Type Physician Office
Facility Name GRANT MEMORIAL HOSPITAL BENSENHAVER MEDICAL CLINIC
Street 100 HOSPITAL DRIVE
City PETERSBURG
State WV
ZIP 26847
Phone 304 257-1944
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/26/2025
Certificate Expiration Date 1/25/2027
Facility Type Physician Office
Lab Director DR. DEWEY F. BENSENHAVER

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