50D2088019 CLIA NUMBER - VILLAGE PEDIATRICS PLLC

Laboratory Demographics

  • CLIA Code: 50D2088019
  • Facility Name: VILLAGE PEDIATRICS PLLC
  • Facility Address: 450 NW GILMAN BLVD STE 105
    ISSAQUAH, WA
    ZIP 98027
  • Facility Phone: 425 651-4242
  • Facility Type: Other - PEDIATRICS CLINIC
  • Facility Type: Waiver
  • Lab Director: STACI S. SCOTT
  • NPI Number: 1720426372
  • Taxonomy: 261QP2300X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 50D2088019
LAB Type Other - PEDIATRICS CLINIC
Facility Name VILLAGE PEDIATRICS PLLC
Street 450 NW GILMAN BLVD STE 105
City ISSAQUAH
State WA
ZIP 98027
Phone 425 651-4242
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/9/2014
Certificate Expiration Date 4/4/2028
Facility Type Other - PEDIATRICS CLINIC
Lab Director STACI S. SCOTT

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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