51D2265663 CLIA NUMBER - PRIME CARE 12 PRIORITY HEALTH

Laboratory Demographics

  • CLIA Code: 51D2265663
  • Facility Name: PRIME CARE 12 PRIORITY HEALTH
  • Facility Address: 702 STAFFORD DRIVE
    PRINCETON, WV
    ZIP 24740
  • Facility Phone: 304 425-0085
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHAWN L. VEST
  • NPI Number: 1396843199
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 51D2265663
LAB Type Physician Office
Facility Name PRIME CARE 12 PRIORITY HEALTH
Street 702 STAFFORD DRIVE
City PRINCETON
State WV
ZIP 24740
Phone 304 425-0085
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/1/2024
Certificate Expiration Date 7/31/2026
Facility Type Physician Office
Lab Director SHAWN L. VEST

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