50D0639873 CLIA NUMBER - COLUMBIA FAMILY CLINIC

Laboratory Demographics

CLIA Number: 50D0639873

Facility Name: COLUMBIA FAMILY CLINIC

Facility Address:
1012 S 3RD ST
DAYTON, WA
ZIP 99328
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Facility Phone Number: 509 382-3200

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1518044551

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	50D0639873
LAB Type	Physician Office
Facility Name	COLUMBIA FAMILY CLINIC
Street	1012 S 3RD ST
City	DAYTON
State	WA
ZIP	99328
Phone	509 382-3200
CertificateType	4
CertificateEffectiveDate	9/1/2004
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

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