50D1107159 CLIA NUMBER - OLYMPIC INTERNAL MEDICINE INC PS

Laboratory Demographics

  • CLIA Code: 50D1107159
  • Facility Name: OLYMPIC INTERNAL MEDICINE INC PS
  • Facility Address: 2620 WHEATON WAY
    BREMERTON, WA
    ZIP 98310
  • Facility Phone: 360 377-3923
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GARY J. GRETCH
  • NPI Number: 1619958162
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 50D1107159
LAB Type Physician Office
Facility Name OLYMPIC INTERNAL MEDICINE INC PS
Street 2620 WHEATON WAY
City BREMERTON
State WA
ZIP 98310
Phone 360 377-3923
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/28/2020
Certificate Expiration Date 4/4/2028
Facility Type Physician Office
Lab Director GARY J. GRETCH

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