50D2059100 CLIA NUMBER - MID-COLUMBIA ENDOSCOOPY CENTER

Laboratory Demographics

  • CLIA Code: 50D2059100
  • Facility Name: MID-COLUMBIA ENDOSCOOPY CENTER
  • Facility Address: 8819 W VICTORIA AVE
    KENNEWICK, WA
    ZIP 99336
  • Facility Phone: 509 460-5500
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: CHAYANIN BOONPONGMANEE
  • NPI Number: 1184926834
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 50D2059100
LAB Type Ambulatory Surgery Center
Facility Name MID-COLUMBIA ENDOSCOOPY CENTER
Street 8819 W VICTORIA AVE
City KENNEWICK
State WA
ZIP 99336
Phone 509 460-5500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/17/2013
Certificate Expiration Date 4/4/2028
Facility Type Ambulatory Surgery Center
Lab Director CHAYANIN BOONPONGMANEE

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