51D2291872 CLIA NUMBER - MONTGOMERY GENERAL HOSPITAL/UROLOGY CLINIC

Laboratory Demographics

  • CLIA Code: 51D2291872
  • Facility Name: MONTGOMERY GENERAL HOSPITAL/UROLOGY CLINIC
  • Facility Address: 401 SIXTH AVENUE SUITE 202
    MONTGOMERY, WV
    ZIP 25136
  • Facility Phone: 304 442-2521
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. SAMMAR ATASSI
  • NPI Number: 1619061702
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 51D2291872
LAB Type Physician Office
Facility Name MONTGOMERY GENERAL HOSPITAL/UROLOGY CLINIC
Street 401 SIXTH AVENUE SUITE 202
City MONTGOMERY
State WV
ZIP 25136
Phone 304 442-2521
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/17/2025
Certificate Expiration Date 10/16/2027
Facility Type Physician Office
Lab Director DR. SAMMAR ATASSI

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