51D2177106 CLIA NUMBER - DOCTORS IMMEDICARE

Laboratory Demographics

  • CLIA Code: 51D2177106
  • Facility Name: DOCTORS IMMEDICARE
  • Facility Address: 160 UNDERCLIFF TERRACE
    PRINCETON, WV
    ZIP 24740
  • Facility Phone: 304 425-0057
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. PRAKASH PURANIK
  • NPI Number: 1134265697
  • Taxonomy: 207L00000X - Anesthesiology

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CLIA Record

Field Name Field Value
CLIA Number 51D2177106
LAB Type Physician Office
Facility Name DOCTORS IMMEDICARE
Street 160 UNDERCLIFF TERRACE
City PRINCETON
State WV
ZIP 24740
Phone 304 425-0057
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/6/2024
Certificate Expiration Date 1/5/2026
Facility Type Physician Office
Lab Director DR. PRAKASH PURANIK

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