50D0900355 CLIA NUMBER - WESTERN WASHINGTON MED GROUP-GI DEPT

Laboratory Demographics

CLIA Number: 50D0900355

Facility Name: WESTERN WASHINGTON MED GROUP-GI DEPT

Facility Address:
4225 HOYT AVENUE SUITE A
EVERETT, WA
ZIP 98203
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Facility Phone Number: 425 259-3122

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1831238443

Taxonomy: 246QH0600X - Specialist/Technologist, Pathology

CLIA Record

Field Name	Field Value
CLIA Number	50D0900355
LAB Type	Physician Office
Facility Name	WESTERN WASHINGTON MED GROUP-GI DEPT
Street	4225 HOYT AVENUE SUITE A
City	EVERETT
State	WA
ZIP	98203
Phone	425 259-3122
CertificateType	3
CertificateEffectiveDate	5/10/2007
CertificateExpirationDate	4/4/2028
FacilityType	PPMP

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