51D2209205 CLIA NUMBER - TUG RIVER HEALTH ASSOCIATION - PRINCETON

Laboratory Demographics

  • CLIA Code: 51D2209205
  • Facility Name: TUG RIVER HEALTH ASSOCIATION - PRINCETON
  • Facility Address: 200 12TH ST SUITE 101
    PRINCETON, WV
    ZIP 24740
  • Facility Phone: 304 431-1400
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. TERESA THACKER
  • NPI Number: 1639842818
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 51D2209205
LAB Type Physician Office
Facility Name TUG RIVER HEALTH ASSOCIATION - PRINCETON
Street 200 12TH ST SUITE 101
City PRINCETON
State WV
ZIP 24740
Phone 304 431-1400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/12/2025
Certificate Expiration Date 1/11/2027
Facility Type Physician Office
Lab Director DR. TERESA THACKER

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