50D0882775 CLIA NUMBER - CEDAR CREEK CORRECTIONS CENTER

Laboratory Demographics

  • CLIA Code: 50D0882775
  • Facility Name: CEDAR CREEK CORRECTIONS CENTER
  • Facility Address: 12200 BORDEAUX RD
    LITTLEROCK, WA
    ZIP 98556
  • Facility Phone: 360 753-7278
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: KELLY REMY
  • NPI Number: 1750672572
  • Taxonomy: 261QP2400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 50D0882775
LAB Type Other
Facility Name CEDAR CREEK CORRECTIONS CENTER
Street 12200 BORDEAUX RD
City LITTLEROCK
State WA
ZIP 98556
Phone 360 753-7278
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/11/2006
Certificate Expiration Date 4/4/2028
Facility Type Other
Lab Director KELLY REMY

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