50D2020659 CLIA NUMBER - HOMETOWN FAMILY MEDICINE PS

Laboratory Demographics

  • CLIA Code: 50D2020659
  • Facility Name: HOMETOWN FAMILY MEDICINE PS
  • Facility Address: 210 W MAIN ST
    RITZVILLE, WA
    ZIP 99169
  • Facility Phone: 509 659-4800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHARLES M. SACKMANN
  • NPI Number: 1881991131
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 50D2020659
LAB Type Physician Office
Facility Name HOMETOWN FAMILY MEDICINE PS
Street 210 W MAIN ST
City RITZVILLE
State WA
ZIP 99169
Phone 509 659-4800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/24/2011
Certificate Expiration Date 4/4/2028
Facility Type Physician Office
Lab Director CHARLES M. SACKMANN

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This page was last updated on: 3/20/2025