Does a med spa have to register or hold a license in West Virginia?

Short answer
Yes — a salon offering aesthetics needs a board-approved salon license, with written notice 20 days before opening for inspection, plus fees; separately, a corporation practicing medicine needs a certificate of authorization from the medical board.

West Virginia licenses the PREMISES through the Board of Barbers and Cosmetologists: before opening, any person, firm or corporation owning or operating a salon must have the salon approved by the board as meeting the requirements for the place of business, notify the board in writing at least twenty days before the proposed opening date so an inspection can be made, and pay the applicable fees. No salon may render a service, except through a licensee or certificate holder, that would be a licensed practice if an individual did it. The chapter’s definition of aesthetics is itself bounded: it reaches the listed acts when done for compensation and not for the treatment of disease. The Board of Barbers and Cosmetologists’ legislative fee rule, Series 6, PRICES the premises in digits: a salon or school opening inspection fee of $50.00, an initial license fee of $40.00 and an annual renewal of $40.00 for a cosmetology, barber, nail technology, hair styling, waxing or aesthetic salon; the practitioner’s license is $35.00 to issue and $35.00 to renew annually, reciprocity $100.00, and a booth or chair rental registration $15.00 with $15.00 annual renewal.