50D0704062 CLIA NUMBER - EASTERN STATE HOSPITAL

Laboratory Demographics

  • CLIA Code: 50D0704062
  • Facility Name: EASTERN STATE HOSPITAL
  • Facility Address: FIR STREET
    MEDICAL LAKE, WA
    ZIP 99022
  • Facility Phone: 509 565-4000
  • Facility Type: Hospital
  • Facility Type: Accreditation
  • Lab Director: DR. SANJAY LOGANI
  • NPI Number: 1679651970
  • Taxonomy: 3336L0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 50D0704062
LAB Type Hospital
Facility Name EASTERN STATE HOSPITAL
Street FIR STREET
City MEDICAL LAKE
State WA
ZIP 99022
Phone 509 565-4000
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 9/1/1992
Certificate Expiration Date 4/4/2028
Facility Type Hospital
Lab Director DR. SANJAY LOGANI

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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