CLIA lab
CLIA 51D2169104: DRS Brock Henderson, Diprisco, Ravelo & Green
Charleston, WV. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 51D2169104 belongs to DRS Brock Henderson, Diprisco, Ravelo & Green in Charleston, WV.
Certificate of Waiver, effective July 16, 2025, expires July 15, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- July 16, 2025
- Certificate expiration
- July 15, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- July 16, 2019
- Facility type
- Other
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
- Directly affiliated labs
- 4
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 51D2169104
- Lab name
- DRS Brock Henderson, Diprisco, Ravelo & Green
- Address
- 4307 Maccorkle Ave SE, Charleston, WV 25304
- Phone
- (304) 760-6221
- Fax
- (304) 721-4172
Annual test volume the lab reported
- Waived tests
- 52
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Affiliated CLIA numbers
Other labs in Charleston, WV
- Affect Therapeutics, IncCertificate of Waiver, Comprehensive outpatient rehab facility51D2284618
- Amedisys West Virginia, LLC DBA Adoration HomeCertificate of Waiver, Home health agency51D1061328
- Appalachian Labs of WVCertificate of Compliance, Independent51D2160356
- Arthur B Hodges Center at Edgewood SummitCertificate of Waiver, Skilled nursing or nursing facility51D2067337
- Bandak Plastic SurgeryCertificate of Waiver, Ambulatory surgery center51D2216430
- Blue Lot MD PLLC DBA DR Letitia TierneyCertificate for Provider-Performed Microscopy Procedures, Physician office51D0858267
- Bma CharlestonCertificate of Waiver, End stage renal disease dialysis facility51D0663820
- Brookdale Charleston GardensCertificate of Waiver, Assisted living facility51D1009383
- Bureau for Public Health Rapid Testing InitiativeCertificate of Waiver, Public health laboratory51D1069373
- Camc DBA Institute for Academic Med CancerCertificate of Waiver, Other51D2341321
Related
Questions
What is the CLIA number for DRS Brock Henderson, Diprisco, Ravelo & Green in Charleston?
51D2169104, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does DRS Brock Henderson, Diprisco, Ravelo & Green hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 51D2169104 expire?
The CMS file lists July 15, 2027 as the certificate expiration date; the certificate took effect July 16, 2025.