51D2193995 CLIA NUMBER - WISHING WELL ALF AT FAIRMONT CAMPUS

Laboratory Demographics

  • CLIA Code: 51D2193995
  • Facility Name: WISHING WELL ALF AT FAIRMONT CAMPUS
  • Facility Address: 1543 COUNTRY CLUB RD
    FAIRMONT, WV
    ZIP 26554
  • Facility Phone: 304 363-2273
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: DR. HUGO CARDUCCI
  • NPI Number: 1942446745
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 51D2193995
LAB Type Assisted Living Facility
Facility Name WISHING WELL ALF AT FAIRMONT CAMPUS
Street 1543 COUNTRY CLUB RD
City FAIRMONT
State WV
ZIP 26554
Phone 304 363-2273
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/28/2024
Certificate Expiration Date 9/27/2026
Facility Type Assisted Living Facility
Lab Director DR. HUGO CARDUCCI

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This page was last updated on: 6/4/2025