50D2087473 CLIA NUMBER - PEACE HEALTH FAMILY MEDICINE AT 87TH AVE

Laboratory Demographics

  • CLIA Code: 50D2087473
  • Facility Name: PEACE HEALTH FAMILY MEDICINE AT 87TH AVE
  • Facility Address: 505 NE 87TH AVE STE 260
    VANCOUVER, WA
    ZIP 98664
  • Facility Phone: 360 514-6450
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PATRICIA WOODEN
  • NPI Number: 1376921627
  • Taxonomy: 133N00000X - Nutritionist

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CLIA Record

Field Name Field Value
CLIA Number 50D2087473
LAB Type Physician Office
Facility Name PEACE HEALTH FAMILY MEDICINE AT 87TH AVE
Street 505 NE 87TH AVE STE 260
City VANCOUVER
State WA
ZIP 98664
Phone 360 514-6450
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/25/2014
Certificate Expiration Date 4/4/2028
Facility Type Physician Office
Lab Director PATRICIA WOODEN

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