50D2003099 CLIA NUMBER - CORNERSTONE MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 50D2003099
  • Facility Name: CORNERSTONE MEDICAL CLINIC
  • Facility Address: 1420 MAIN ST
    SUMNER, WA
    ZIP 98390
  • Facility Phone: 253 987-5156
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BENIGNO W. DAGAN
  • NPI Number: 1235460676
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 50D2003099
LAB Type Physician Office
Facility Name CORNERSTONE MEDICAL CLINIC
Street 1420 MAIN ST
City SUMNER
State WA
ZIP 98390
Phone 253 987-5156
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/2/2010
Certificate Expiration Date 4/4/2028
Facility Type Physician Office
Lab Director BENIGNO W. DAGAN

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