NORTH FORK PRIMARY CARE CLINIC
NPI 1346442134
Clinical Medical Laboratory in Riverton, WV

Active since June 04, 2007CLIA 51D0661868 · Microscopy
16921 MOUNTAINEER DRIVE, RIVERTON, WV 26814(304) 567-2101(304) 567-2102 Get Directions Write a Review

NPPES record last updated: July 19, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About North Fork Primary Care Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NORTH FORK PRIMARY CARE CLINIC (NPI 1346442134) is a healthcare organization registered as a clinical medical laboratory in Riverton, West Virginia and active in the NPI registry since June 2007. The organization holds a CLIA Microscopy certificate valid through June 6, 2027 and lists Jamie Hudson, Ceo, as its authorized official.

NPPES Registry Identity

NPI1346442134
Entity TypeOrganization
Primary Taxonomy291U00000X
Legal Business NamePENDLETON COMMUNITY CARE, INC.
Location Address16921 MOUNTAINEER DRIVERiverton, WV 26814-0101
Mailing AddressPo Box 101Riverton, WV 26814-0101 · (304) 567-2101 · Fax (304) 567-2102
Fax(304) 567-2102
Organization SubpartNo
Authorized OfficialJamie HudsonCeo · (304) 358-7230
Enumeration DateJune 4, 2007
Last NPPES UpdateJuly 19, 2016
NPI 1346442134 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinical Medical LaboratoryLaboratories
Taxonomy Code291U00000X
License Licensed in WV · 51D0661868
Definition
(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.
16921 MOUNTAINEER DRIVE, Riverton, WV 26814

Other Names 1

Doing Business AsNorth Fork Primary Care Clinic

Other Identifiers 2

Medicare PIN5118821WV
Medicaid3810006211WV

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 51D0661868

North Fork Primary Care · Riverton, WV
Active · expires Jun 6, 2027
CLIA Number51D0661868
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateJune 7, 2025
Certificate Expiration DateJune 6, 2027
Laboratory DirectorMs. Mary Ellen Wimer
Laboratory Phone(304) 567-2101
Laboratory LocationNorth Fork Primary Care16921 Mountaineer Drive, Riverton, WV 26814
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Federally Qualified Health Center (FQHC))
16921 MOUNTAINEER DRIVE
RIVERTON, WV 26814
Nurse Practitioner (Family)
16921 MOUNTAINEER DRIVE
RIVERTON, WV 26814

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pendleton Community Care, Inc.'s NPI number?

The NPI number for Pendleton Community Care, Inc. is 1346442134. It was assigned to this organization in the NPPES registry on June 4, 2007. The provider is doing business as North Fork Primary Care Clinic.

Where is Pendleton Community Care, Inc. located?

Pendleton Community Care, Inc. is located at 16921 Mountaineer Drive, Riverton, WV 26814. The listed phone number is (304) 567-2101.

What is Pendleton Community Care, Inc.'s specialty?

The primary specialty registered for this NPI is Clinical Medical Laboratory with taxonomy code 291U00000X.

Does Pendleton Community Care, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 51D0661868) is associated with this NPI, valid through June 6, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Pendleton Community Care, Inc. was last updated on July 19, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.