50D2013819 CLIA NUMBER - MOLINA HEALTHCARE OF WA

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Laboratory Demographics

CLIA Number: 50D2013819

Facility Name: MOLINA HEALTHCARE OF WA

Facility Address:
15 SW EVERETT MALL WAY STE A
EVERETT, WA
ZIP 98208
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Facility Phone Number: 425 348-6727

Facility Type: Other - CLINIC

Certificate Type: Waiver

NPI Number: 1891000725

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	50D2013819
LAB Type	Other - CLINIC
Facility Name	MOLINA HEALTHCARE OF WA
Street	15 SW EVERETT MALL WAY STE A
City	EVERETT
State	WA
ZIP	98208
Phone	425 348-6727
CertificateType	4
CertificateEffectiveDate	9/24/2010
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

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