50D2087148 CLIA NUMBER - PROVIDENCE SURGERY AND PROCEDURE CENTER

Laboratory Demographics

  • CLIA Code: 50D2087148
  • Facility Name: PROVIDENCE SURGERY AND PROCEDURE CENTER
  • Facility Address: 16528 E DESMET CT STE A2100
    SPOKANE VALLEY, WA
    ZIP 99216
  • Facility Phone: 509 944-8960
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: BRYAN MITCHELL
  • NPI Number: 1205545860
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 50D2087148
LAB Type Ambulatory Surgery Center
Facility Name PROVIDENCE SURGERY AND PROCEDURE CENTER
Street 16528 E DESMET CT STE A2100
City SPOKANE VALLEY
State WA
ZIP 99216
Phone 509 944-8960
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/5/2023
Certificate Expiration Date 4/4/2028
Facility Type Ambulatory Surgery Center
Lab Director BRYAN MITCHELL

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