50D0968052 CLIA NUMBER - HAWKS PRAIRIE FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 50D0968052
  • Facility Name: HAWKS PRAIRIE FAMILY MEDICINE
  • Facility Address: 2555 MARVIN RD NE
    LACEY, WA
    ZIP 98516
  • Facility Phone: 360 413-4200
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MEGHAN DUFFIE
  • NPI Number: 1952583536
  • Taxonomy: 305R00000X - Preferred Provider Organization

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CLIA Record

Field Name Field Value
CLIA Number 50D0968052
LAB Type Physician Office
Facility Name HAWKS PRAIRIE FAMILY MEDICINE
Street 2555 MARVIN RD NE
City LACEY
State WA
ZIP 98516
Phone 360 413-4200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/30/2025
Certificate Expiration Date 4/4/2028
Facility Type Physician Office
Lab Director MEGHAN DUFFIE

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