50D0638563 CLIA NUMBER - KITTITAS VALLEY HEALTHCARE LABORATORY

Laboratory Demographics

CLIA Number: 50D0638563

Facility Name: KITTITAS VALLEY HEALTHCARE LABORATORY

Facility Address:
603 S CHESTNUT ST
ELLENSBURG, WA
ZIP 98926
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Facility Phone Number: 509 962-9841

Facility Type: Hospital

Certificate Type: Accreditation

NPI Number: 1851762090

Taxonomy: 363LP0808X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	50D0638563
LAB Type	Hospital
Facility Name	KITTITAS VALLEY HEALTHCARE LABORATORY
Street	603 S CHESTNUT ST
City	ELLENSBURG
State	WA
ZIP	98926
Phone	509 962-9841
CertificateType	1
CertificateEffectiveDate	10/28/2019
CertificateExpirationDate	4/4/2028
FacilityType	Accreditation

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