50D0911333 CLIA NUMBER - JEFFERSON HEALTHCARE SOUTH COUNTY MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 50D0911333
  • Facility Name: JEFFERSON HEALTHCARE SOUTH COUNTY MEDICAL CLINIC
  • Facility Address: 294843 HIGHWAY 101
    QUILCENE, WA
    ZIP 98376
  • Facility Phone: 360 765-3111
  • Facility Type: Other
  • Facility Type: Microscopy
  • Lab Director: SHANNAN KIRCHNER
  • NPI Number: 1336575000
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 50D0911333
LAB Type Other
Facility Name JEFFERSON HEALTHCARE SOUTH COUNTY MEDICAL CLINIC
Street 294843 HIGHWAY 101
City QUILCENE
State WA
ZIP 98376
Phone 360 765-3111
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 8/1/2002
Certificate Expiration Date 4/4/2028
Facility Type Other
Lab Director SHANNAN KIRCHNER

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