50D1092367 CLIA NUMBER - PUYALLUP ENDOSCOPY CENTER

Laboratory Demographics

  • CLIA Code: 50D1092367
  • Facility Name: PUYALLUP ENDOSCOPY CENTER
  • Facility Address: 1703 S MERIDIAN STE 203
    PUYALLUP, WA
    ZIP 98371
  • Facility Phone: 253 841-3933
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JONATHAN HURST, MD
  • NPI Number: 1790744175
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 50D1092367
LAB Type Ambulatory Surgery Center
Facility Name PUYALLUP ENDOSCOPY CENTER
Street 1703 S MERIDIAN STE 203
City PUYALLUP
State WA
ZIP 98371
Phone 253 841-3933
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/21/2008
Certificate Expiration Date 4/4/2028
Facility Type Ambulatory Surgery Center
Lab Director JONATHAN HURST, MD

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