51D2154610 CLIA NUMBER - MOUNTAIN STATE MEDICAL SPECIALTIES, INC

Laboratory Demographics

  • CLIA Code: 51D2154610
  • Facility Name: MOUNTAIN STATE MEDICAL SPECIALTIES, INC
  • Facility Address: 76 16TH STREET, SUITE 100A
    WHEELING, WV
    ZIP 26003
  • Facility Phone: 304 238-7600
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. DAVID C. CARLISLE
  • NPI Number: 1760659478
  • Taxonomy: 261QP2000X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 51D2154610
LAB Type Physician Office
Facility Name MOUNTAIN STATE MEDICAL SPECIALTIES, INC
Street 76 16TH STREET, SUITE 100A
City WHEELING
State WV
ZIP 26003
Phone 304 238-7600
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 9/17/2024
Certificate Expiration Date 9/16/2026
Facility Type Physician Office
Lab Director DR. DAVID C. CARLISLE

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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