50D0638796 CLIA NUMBER - PROVIDENCE MOUNT CARMEL HOSPITAL

Laboratory Demographics

CLIA Number: 50D0638796

Facility Name: PROVIDENCE MOUNT CARMEL HOSPITAL

Facility Address:
982 E COLUMBIA AVE
COLVILLE, WA
ZIP 99114
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Facility Phone Number: 509 685-5320

Facility Type: Hospital

Certificate Type: Certificate of Compliance

NPI Number: 1881631646

Taxonomy: 282NC0060X - General Acute Care Hospital

CLIA Record

Field Name	Field Value
CLIA Number	50D0638796
LAB Type	Hospital
Facility Name	PROVIDENCE MOUNT CARMEL HOSPITAL
Street	982 E COLUMBIA AVE
City	COLVILLE
State	WA
ZIP	99114
Phone	509 685-5320
CertificateType	2
CertificateEffectiveDate	8/11/2006
CertificateExpirationDate	4/4/2028
FacilityType	Compliance

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