50D0639177 CLIA NUMBER - BEAR CREEK PEDIATRICS

Laboratory Demographics

  • CLIA Code: 50D0639177
  • Facility Name: BEAR CREEK PEDIATRICS
  • Facility Address: 1410 N MULLAN RD STE 200
    SPOKANE, WA
    ZIP 99206
  • Facility Phone: 509 838-1188
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: SASHA A. HULL
  • NPI Number: 1518470137
  • Taxonomy: 363LP0200X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 50D0639177
LAB Type Physician Office
Facility Name BEAR CREEK PEDIATRICS
Street 1410 N MULLAN RD STE 200
City SPOKANE
State WA
ZIP 99206
Phone 509 838-1188
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/1992
Certificate Expiration Date 4/4/2028
Facility Type Physician Office
Lab Director SASHA A. HULL

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This page was last updated on: 9/29/2025