50D0898334 CLIA NUMBER - OVERLAKE FAMILY PRACTICE, PS

Laboratory Demographics

CLIA Number: 50D0898334

Facility Name: OVERLAKE FAMILY PRACTICE, PS

Facility Address:
1048 W LAKE SAMMAMISH PKWY NE
BELLEVUE, WA
ZIP 98008
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Facility Phone Number: 425 562-2000

Facility Type: Practitioner Other

Certificate Type: Microscopy

NPI Number: 1386923654

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	50D0898334
LAB Type	Practitioner Other
Facility Name	OVERLAKE FAMILY PRACTICE, PS
Street	1048 W LAKE SAMMAMISH PKWY NE
City	BELLEVUE
State	WA
ZIP	98008
Phone	425 562-2000
CertificateType	3
CertificateEffectiveDate	7/26/1996
CertificateExpirationDate	4/4/2028
FacilityType	PPMP

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This page was last updated on: 4/23/2024