51D2297535 CLIA NUMBER - JACKSON MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 51D2297535
  • Facility Name: JACKSON MEDICAL CENTER
  • Facility Address: 174 PINNELL STREET, SUITE C
    RIPLEY, WV
    ZIP 25271
  • Facility Phone: 304 373-1599
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PATRICIA SWANN
  • NPI Number: 1467675769
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 51D2297535
LAB Type Physician Office
Facility Name JACKSON MEDICAL CENTER
Street 174 PINNELL STREET, SUITE C
City RIPLEY
State WV
ZIP 25271
Phone 304 373-1599
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/18/2024
Certificate Expiration Date 1/17/2026
Facility Type Physician Office
Lab Director PATRICIA SWANN

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This page was last updated on: 6/4/2025