50D0704436 CLIA NUMBER - EVERGREEN HEALTH DIABETES AND ENDOCRINOLOGY

Laboratory Demographics

  • CLIA Code: 50D0704436
  • Facility Name: EVERGREEN HEALTH DIABETES AND ENDOCRINOLOGY
  • Facility Address: 12333 NE 130TH LN STE TAN 400
    KIRKLAND, WA
    ZIP 98034
  • Facility Phone: 425 899-6414
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: KOMAL C. PATIL-SISDDIA
  • NPI Number: 1508258765
  • Taxonomy: 282N00000X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 50D0704436
LAB Type Physician Office
Facility Name EVERGREEN HEALTH DIABETES AND ENDOCRINOLOGY
Street 12333 NE 130TH LN STE TAN 400
City KIRKLAND
State WA
ZIP 98034
Phone 425 899-6414
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/1992
Certificate Expiration Date 4/4/2028
Facility Type Physician Office
Lab Director KOMAL C. PATIL-SISDDIA

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This page was last updated on: 6/4/2025