51D2295419 CLIA NUMBER - EA HAWSE HEALTH CENTER, INC LOVE CLINIC

Laboratory Demographics

CLIA Number: 51D2295419

Facility Name: EA HAWSE HEALTH CENTER, INC LOVE CLINIC

Facility Address:
112 KUYKENDALL LANE
MOOREFIELD, WV
ZIP 26836
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Facility Phone Number: 304 530-7755

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy

NPI Number: 1639771140

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	51D2295419
LAB Type	Federally Qualified Health Center
Facility Name	EA HAWSE HEALTH CENTER, INC LOVE CLINIC
Street	112 KUYKENDALL LANE
City	MOOREFIELD
State	WV
ZIP	26836
Phone	304 530-7755
CertificateType	3
CertificateEffectiveDate	12/12/2023
CertificateExpirationDate	12/11/2025
FacilityType	PPMP

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This page was last updated on: 4/23/2024