50D2071138 CLIA NUMBER - PROVIDENCE VALLEY YOUNG PEOPLE'S CLINIC

Laboratory Demographics

  • CLIA Code: 50D2071138
  • Facility Name: PROVIDENCE VALLEY YOUNG PEOPLE'S CLINIC
  • Facility Address: 1414 N VERCLER RD STE 1
    SPOKANE, WA
    ZIP 99216
  • Facility Phone: 509 928-6383
  • Facility Type: Other - CLINIC
  • Facility Type: Waiver
  • Lab Director: LEDEL JAN RAMOS

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CLIA Record

Field Name Field Value
CLIA Number 50D2071138
LAB Type Other - CLINIC
Facility Name PROVIDENCE VALLEY YOUNG PEOPLE'S CLINIC
Street 1414 N VERCLER RD STE 1
City SPOKANE
State WA
ZIP 99216
Phone 509 928-6383
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/3/2014
Certificate Expiration Date 4/4/2028
Facility Type Other - CLINIC
Lab Director LEDEL JAN RAMOS

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This page was last updated on: 6/4/2025