51D2188808 CLIA NUMBER - STARLIGHT BEHAVIORAL HEALTH

Laboratory Demographics

  • CLIA Code: 51D2188808
  • Facility Name: STARLIGHT BEHAVIORAL HEALTH
  • Facility Address: 203 LOWER OVERLOOK DRIVE
    HURRICANE, WV
    ZIP 25526
  • Facility Phone: (681) 233-3106
  • Facility Type: Intermediate Care Facility for Mentally Retarded
  • Facility Type: Waiver
  • Lab Director: JACQUELINE D. TANNER
  • NPI Number: 1225685498
  • Taxonomy: 315P00000X - Intermediate Care Facility, Intellectual Disabilities

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CLIA Record

Field Name Field Value
CLIA Number 51D2188808
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name STARLIGHT BEHAVIORAL HEALTH
Street 203 LOWER OVERLOOK DRIVE
City HURRICANE
State WV
ZIP 25526
Phone 6812333106
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/22/2024
Certificate Expiration Date 7/21/2026
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director JACQUELINE D. TANNER

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This page was last updated on: 5/18/2026