50D0932635 CLIA NUMBER - WOODCREEK PEDIATRICS- MARY BRIDGE CHILDREN'S

Laboratory Demographics

  • CLIA Code: 50D0932635
  • Facility Name: WOODCREEK PEDIATRICS- MARY BRIDGE CHILDREN'S
  • Facility Address: 11102 SUNRISE BLVD E STE 103
    PUYALLUP, WA
    ZIP 98374
  • Facility Phone: 253 848-8797
  • Facility Type: Other
  • Facility Type: Certificate of Compliance
  • Lab Director: CALVIN A. KIERUM
  • NPI Number: 1700396652
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 50D0932635
LAB Type Other
Facility Name WOODCREEK PEDIATRICS- MARY BRIDGE CHILDREN'S
Street 11102 SUNRISE BLVD E STE 103
City PUYALLUP
State WA
ZIP 98374
Phone 253 848-8797
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 8/25/1997
Certificate Expiration Date 4/4/2028
Facility Type Other
Lab Director CALVIN A. KIERUM

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