51D2216950 CLIA NUMBER - LIVELY PEDIATRICS, PLLC

Laboratory Demographics

  • CLIA Code: 51D2216950
  • Facility Name: LIVELY PEDIATRICS, PLLC
  • Facility Address: 466 COURTHOUSE ROAD
    PRINCETON, WV
    ZIP 24740
  • Facility Phone: 304 952-2087
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. TARA L. MITCHELL
  • NPI Number: 1063006047
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 51D2216950
LAB Type Physician Office
Facility Name LIVELY PEDIATRICS, PLLC
Street 466 COURTHOUSE ROAD
City PRINCETON
State WV
ZIP 24740
Phone 304 952-2087
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/17/2025
Certificate Expiration Date 3/16/2027
Facility Type Physician Office
Lab Director DR. TARA L. MITCHELL

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