50D1051084 CLIA NUMBER - PACIFIC SURGICAL CENTER

Laboratory Demographics

  • CLIA Code: 50D1051084
  • Facility Name: PACIFIC SURGICAL CENTER
  • Facility Address: 625 9TH AVE
    LONGVIEW, WA
    ZIP 98632
  • Facility Phone: 360 442-7900
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: PETER KUNG
  • NPI Number: 1750481453
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 50D1051084
LAB Type Ambulatory Surgery Center
Facility Name PACIFIC SURGICAL CENTER
Street 625 9TH AVE
City LONGVIEW
State WA
ZIP 98632
Phone 360 442-7900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/21/2006
Certificate Expiration Date 4/4/2028
Facility Type Ambulatory Surgery Center
Lab Director PETER KUNG

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