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50D2025752 CLIA NUMBER - PROLIANCE PUGET SOUND ORTHOPAEDICS

Laboratory Demographics

CLIA Number: 50D2025752

Facility Name: PROLIANCE PUGET SOUND ORTHOPAEDICS

Facility Address:
1724 W UNION AVE STE 100
TACOMA, WA
ZIP 98405
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Facility Phone Number: 253 264-8100

Facility Type: Other - CLINIC

Certificate Type: Waiver
NPI Number: 1205960226

Taxonomy: 207KI0005X - Allergy & Immunology
An allergy and immunology physician who specializes in clinical and laboratory immunology disease management. Source: National Uniform Claim Committee, 2022 Additional Resources: A certification was, but is no longer, issued by the American Board of Allergy and Immunology.

CLIA Record

Field Name Field Value
CLIA Number 50D2025752
LAB Type Other - CLINIC
Facility Name PROLIANCE PUGET SOUND ORTHOPAEDICS
Street 1724 W UNION AVE STE 100
City TACOMA
State WA
ZIP 98405
Phone 253 264-8100
CertificateType 4
CertificateEffectiveDate 6/16/2011
CertificateExpirationDate 4/4/2028
FacilityType Waiver

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