Who can inject
MD/DO, NP/PA under physician supervision, RN under physician delegation
Registered nurses (RNs)
Yes, under physician delegation and supervision
Nurse practitioners & physician assistants
NP/PA may inject under physician collaboration; independent practice limited
The exam that makes it legal
Required; in-person exam before treatment A valid order or good-faith exam by an authorized provider is what makes an injection lawful — not simply who holds the syringe.
Training expected
No state-mandated injector training beyond licensure.
What to verify in West Virginia
Ensure a licensed physician medical director is in place before opening and verify delegation protocols with your state medical board.
Primary source: West Virginia Medical Board
General business information for West Virginia medical-spa owners, current as of 2026 — not legal advice. State boards update rules often; confirm specifics with the West Virginia board (and your own counsel) before you act.