50D1099043 CLIA NUMBER - EVERGREEN RADIA IMAGING CENTER

Laboratory Demographics

  • CLIA Code: 50D1099043
  • Facility Name: EVERGREEN RADIA IMAGING CENTER
  • Facility Address: 11521 NE 128TH ST STE 200
    KIRKLAND, WA
    ZIP 98034
  • Facility Phone: (425) 952-6100
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: DAWN HASTREITER
  • NPI Number: 1922095694
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 50D1099043
LAB Type Practitioner Other
Facility Name EVERGREEN RADIA IMAGING CENTER
Street 11521 NE 128TH ST STE 200
City KIRKLAND
State WA
ZIP 98034
Phone 4259526100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/4/2009
Certificate Expiration Date 4/4/2028
Facility Type Practitioner Other
Lab Director DAWN HASTREITER

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This page was last updated on: 5/18/2026