50D0661518 CLIA NUMBER - NORTHWEST MEDICAL SPECIALTIES, PLLC

Laboratory Demographics

CLIA Number: 50D0661518

Facility Name: NORTHWEST MEDICAL SPECIALTIES, PLLC

Facility Address:
2920 S MERIDIAN STE 100
PUYALLUP, WA
ZIP 98373
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Facility Phone Number: (253) 841-4296

Facility Type: PHYSICIAN OFFICE

Certificate Type: Certificate of Compliance

NPI Number: 1588052245

Taxonomy: 207RH0003X - Internal Medicine
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

CLIA Record

Field Name	Field Value
CLIA Number	50D0661518
LAB Type	PHYSICIAN OFFICE
Facility Name	NORTHWEST MEDICAL SPECIALTIES, PLLC
Street	2920 S MERIDIAN STE 100
City	PUYALLUP
State	WA
ZIP	98373
Phone	(253) 841-4296

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This page was last updated on: 5/11/2023