50D1011516 CLIA NUMBER - PROLIANCE EDMONDS CENTER FOR OUTPATIENT SURGERY

Laboratory Demographics

  • CLIA Code: 50D1011516
  • Facility Name: PROLIANCE EDMONDS CENTER FOR OUTPATIENT SURGERY
  • Facility Address: 7320 216TH ST SW STE 140
    EDMONDS, WA
    ZIP 98026
  • Facility Phone: 425 673-3750
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JUSTIN OLSEN
  • NPI Number: 1295775369
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 50D1011516
LAB Type Ambulatory Surgery Center
Facility Name PROLIANCE EDMONDS CENTER FOR OUTPATIENT SURGERY
Street 7320 216TH ST SW STE 140
City EDMONDS
State WA
ZIP 98026
Phone 425 673-3750
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/25/2004
Certificate Expiration Date 4/4/2028
Facility Type Ambulatory Surgery Center
Lab Director JUSTIN OLSEN

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