50D0638453 CLIA NUMBER - YAKIMA PEDIATRICS

Laboratory Demographics

CLIA Number: 50D0638453

Facility Name: YAKIMA PEDIATRICS

Facility Address:
402 S 12TH AVE
YAKIMA, WA
ZIP 98902
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Facility Phone Number: 509 575-0114

Facility Type: Community Clinic

Certificate Type: Microscopy

NPI Number: 1588110464

Taxonomy: 1223P0221X - Dentist
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

CLIA Record

Field Name	Field Value
CLIA Number	50D0638453
LAB Type	Community Clinic
Facility Name	YAKIMA PEDIATRICS
Street	402 S 12TH AVE
City	YAKIMA
State	WA
ZIP	98902
Phone	509 575-0114
CertificateType	3
CertificateEffectiveDate	10/13/1998
CertificateExpirationDate	4/4/2028
FacilityType	PPMP

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