51D2312217 CLIA NUMBER - MOUNTAIN HEART COMMUNITY SERVICES

Laboratory Demographics

  • CLIA Code: 51D2312217
  • Facility Name: MOUNTAIN HEART COMMUNITY SERVICES
  • Facility Address: 33 MOUNTAIN HEART LANE
    MATHENY, WV
    ZIP 24860
  • Facility Phone: 304 682-8271
  • Facility Type: School/Student Health Service
  • Facility Type: Waiver
  • Lab Director: SUSAN STAFFORD
  • NPI Number: 1679964738
  • Taxonomy: 252Y00000X - Early Intervention Provider Agency

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CLIA Record

Field Name Field Value
CLIA Number 51D2312217
LAB Type School/Student Health Service
Facility Name MOUNTAIN HEART COMMUNITY SERVICES
Street 33 MOUNTAIN HEART LANE
City MATHENY
State WV
ZIP 24860
Phone 304 682-8271
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/7/2024
Certificate Expiration Date 10/6/2026
Facility Type School/Student Health Service
Lab Director SUSAN STAFFORD

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