50D0630980 CLIA NUMBER - SNOQUALMIE RIDGE MEDICAL CLINIC

Laboratory Demographics

CLIA Number: 50D0630980

Facility Name: SNOQUALMIE RIDGE MEDICAL CLINIC

Facility Address:
35020 SE KINSEY ST
SNOQUALMIE, WA
ZIP 98065
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Facility Phone Number: 425 396-7682

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1548716830

Taxonomy: 261QD0000X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	50D0630980
LAB Type	Physician Office
Facility Name	SNOQUALMIE RIDGE MEDICAL CLINIC
Street	35020 SE KINSEY ST
City	SNOQUALMIE
State	WA
ZIP	98065
Phone	425 396-7682
CertificateType	3
CertificateEffectiveDate	6/1/1996
CertificateExpirationDate	4/4/2028
FacilityType	PPMP

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This page was last updated on: 4/23/2024