50D1096972 CLIA NUMBER - CREEKSIDE SURGERY CENTER

Laboratory Demographics

CLIA Number: 50D1096972

Facility Name: CREEKSIDE SURGERY CENTER

Facility Address:
2400 RACQUET LN
YAKIMA, WA
ZIP 98902
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Facility Phone Number: 509 225-3668

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1730180746

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	50D1096972
LAB Type	Ambulatory Surgery Center
Facility Name	CREEKSIDE SURGERY CENTER
Street	2400 RACQUET LN
City	YAKIMA
State	WA
ZIP	98902
Phone	509 225-3668
CertificateType	4
CertificateEffectiveDate	3/16/2009
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

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This page was last updated on: 4/23/2024