51D2321624 CLIA NUMBER - WALLS WELLNESS CENTER, LLC

Laboratory Demographics

  • CLIA Code: 51D2321624
  • Facility Name: WALLS WELLNESS CENTER, LLC
  • Facility Address: 149 JERRY WEST HIGHWAY, SUITE 2A
    LOGAN, WV
    ZIP 25601
  • Facility Phone: 304 752-5100
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JULIE A. WALLS
  • NPI Number: 1043817471
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 51D2321624
LAB Type Physician Office
Facility Name WALLS WELLNESS CENTER, LLC
Street 149 JERRY WEST HIGHWAY, SUITE 2A
City LOGAN
State WV
ZIP 25601
Phone 304 752-5100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/7/2025
Certificate Expiration Date 4/6/2027
Facility Type Physician Office
Lab Director JULIE A. WALLS

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