50D1050066 CLIA NUMBER - HERITAGE FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 50D1050066
  • Facility Name: HERITAGE FAMILY MEDICINE
  • Facility Address: 4001 HARRISON AVE NW STE 101
    OLYMPIA, WA
    ZIP 98502
  • Facility Phone: 360 704-2362
  • Facility Type: Other - CLINIC
  • Facility Type: Waiver
  • Lab Director: AMANDEEP K. MANN
  • NPI Number: 1023449006
  • Taxonomy: 208100000X - Physical Medicine & Rehabilitation

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 50D1050066
LAB Type Other - CLINIC
Facility Name HERITAGE FAMILY MEDICINE
Street 4001 HARRISON AVE NW STE 101
City OLYMPIA
State WA
ZIP 98502
Phone 360 704-2362
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/30/2018
Certificate Expiration Date 4/4/2028
Facility Type Other - CLINIC
Lab Director AMANDEEP K. MANN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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