51D2189859 CLIA NUMBER - MKSC, INC DBA MARRA KNEE AND SHOULDER CENTER, INC

Laboratory Demographics

  • CLIA Code: 51D2189859
  • Facility Name: MKSC, INC DBA MARRA KNEE AND SHOULDER CENTER, INC
  • Facility Address: 300 WHARTON CIRCLE STE 130
    TRIADELPHIA, WV
    ZIP 26059
  • Facility Phone: 304 242-8042
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PHILLIP J. MARQUART
  • NPI Number: 1003218397
  • Taxonomy: 207X00000X - Orthopaedic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 51D2189859
LAB Type Physician Office
Facility Name MKSC, INC DBA MARRA KNEE AND SHOULDER CENTER, INC
Street 300 WHARTON CIRCLE STE 130
City TRIADELPHIA
State WV
ZIP 26059
Phone 304 242-8042
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/6/2024
Certificate Expiration Date 8/5/2026
Facility Type Physician Office
Lab Director PHILLIP J. MARQUART

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