50D2060908 CLIA NUMBER - MERCER ISLAND FAMILIY MEDICINE

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Laboratory Demographics

CLIA Number: 50D2060908

Facility Name: MERCER ISLAND FAMILIY MEDICINE

Facility Address:
3003 ISLAND CREST WAY
MERCER ISLAND, WA
ZIP 98040
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Facility Phone Number: 206 275-3487

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1083196232

Taxonomy: 261QM0801X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	50D2060908
LAB Type	Physician Office
Facility Name	MERCER ISLAND FAMILIY MEDICINE
Street	3003 ISLAND CREST WAY
City	MERCER ISLAND
State	WA
ZIP	98040
Phone	206 275-3487
CertificateType	4
CertificateEffectiveDate	6/20/2013
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

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