50D0956753 CLIA NUMBER - PENINSULA DERMATOLOGY & LASER CLINIC

Laboratory Demographics

CLIA Number: 50D0956753

Facility Name: PENINSULA DERMATOLOGY & LASER CLINIC

Facility Address:
3505 NW ANDERSON HILL RD STE 201
SILVERDALE, WA
ZIP 98383
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Facility Phone Number: 360 698-6859

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1942861000

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	50D0956753
LAB Type	Physician Office
Facility Name	PENINSULA DERMATOLOGY & LASER CLINIC
Street	3505 NW ANDERSON HILL RD STE 201
City	SILVERDALE
State	WA
ZIP	98383
Phone	360 698-6859
CertificateType	2
CertificateEffectiveDate	2/4/1999
CertificateExpirationDate	4/4/2028
FacilityType	Compliance

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