50D0703174 CLIA NUMBER - SKOKOMISH HEALTH CLINIC

Laboratory Demographics

  • CLIA Code: 50D0703174
  • Facility Name: SKOKOMISH HEALTH CLINIC
  • Facility Address: 100 N TRIBAL CENTER ROAD
    SHELTON, WA
    ZIP 98584
  • Facility Phone: 360 426-5755
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: NICOLE M. GIBSON
  • NPI Number: 1528264561
  • Taxonomy: 101YA0400X - Counselor

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CLIA Record

Field Name Field Value
CLIA Number 50D0703174
LAB Type Federally Qualified Health Center
Facility Name SKOKOMISH HEALTH CLINIC
Street 100 N TRIBAL CENTER ROAD
City SHELTON
State WA
ZIP 98584
Phone 360 426-5755
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Federally Qualified Health Center
Lab Director NICOLE M. GIBSON

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