50D0709589 CLIA NUMBER - OLYMPIA INTERNAL MEDICINE ASSOCIATES PLLC

Laboratory Demographics

  • CLIA Code: 50D0709589
  • Facility Name: OLYMPIA INTERNAL MEDICINE ASSOCIATES PLLC
  • Facility Address: 3701 ENSIGN RD NE STE B
    OLYMPIA, WA
    ZIP 98506
  • Facility Phone: 360 763-5681
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ROBERT J. WIDROW
  • NPI Number: 1922031855
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 50D0709589
LAB Type Physician Office
Facility Name OLYMPIA INTERNAL MEDICINE ASSOCIATES PLLC
Street 3701 ENSIGN RD NE STE B
City OLYMPIA
State WA
ZIP 98506
Phone 360 763-5681
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 8/8/2000
Certificate Expiration Date 4/4/2028
Facility Type Physician Office
Lab Director ROBERT J. WIDROW

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