50D0638061 CLIA NUMBER - COULEE CITY MEDICAL CLINIC

Laboratory Demographics

CLIA Number: 50D0638061

Facility Name: COULEE CITY MEDICAL CLINIC

Facility Address:
130 NORTH ADAMS
COULEE CITY, WA
ZIP 99115
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Facility Phone Number: 509 632-5701

Facility Type: Community Clinic

Certificate Type: Microscopy

NPI Number: 1689722472

Taxonomy: 261QC1500X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	50D0638061
LAB Type	Community Clinic
Facility Name	COULEE CITY MEDICAL CLINIC
Street	130 NORTH ADAMS
City	COULEE CITY
State	WA
ZIP	99115
Phone	509 632-5701
CertificateType	3
CertificateEffectiveDate	5/27/1997
CertificateExpirationDate	4/4/2028
FacilityType	PPMP

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