50D2078838 CLIA NUMBER - EASTSIDE MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 50D2078838
  • Facility Name: EASTSIDE MEDICAL GROUP
  • Facility Address: 1301 4TH AVE NW STE 201
    ISSAQUAH, WA
    ZIP 98027
  • Facility Phone: 425 270-3713
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MICHAEL RIZEN
  • NPI Number: 1750709358
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 50D2078838
LAB Type Ambulatory Surgery Center
Facility Name EASTSIDE MEDICAL GROUP
Street 1301 4TH AVE NW STE 201
City ISSAQUAH
State WA
ZIP 98027
Phone 425 270-3713
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/4/2014
Certificate Expiration Date 4/4/2028
Facility Type Ambulatory Surgery Center
Lab Director MICHAEL RIZEN

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