50D0671737 CLIA NUMBER - PACIFIC COUNTY HHS DEPARTMENT

Laboratory Demographics

CLIA Number: 50D0671737

Facility Name: PACIFIC COUNTY HHS DEPARTMENT

Facility Address:
1216 W ROBERT BUSH DR
SOUTH BEND, WA
ZIP 98586
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Facility Phone Number: 360 875-9343

Facility Type: Other

Certificate Type: Microscopy

NPI Number: 1508939513

Taxonomy: 282NC0060X - General Acute Care Hospital

CLIA Record

Field Name	Field Value
CLIA Number	50D0671737
LAB Type	Other
Facility Name	PACIFIC COUNTY HHS DEPARTMENT
Street	1216 W ROBERT BUSH DR
City	SOUTH BEND
State	WA
ZIP	98586
Phone	360 875-9343
CertificateType	3
CertificateEffectiveDate	9/1/1992
CertificateExpirationDate	4/4/2028
FacilityType	PPMP

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