50D2105877 CLIA NUMBER - VALLEY ROOTS FAMILY CARE

Laboratory Demographics

CLIA Number: 50D2105877

Facility Name: VALLEY ROOTS FAMILY CARE

Facility Address:
617 W DIVISION ST
MOUNT VERNON, WA
ZIP 98273
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Facility Phone Number: 360 428-1884

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1144693250

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	50D2105877
LAB Type	Physician Office
Facility Name	VALLEY ROOTS FAMILY CARE
Street	617 W DIVISION ST
City	MOUNT VERNON
State	WA
ZIP	98273
Phone	360 428-1884
CertificateType	4
CertificateEffectiveDate	12/4/2015
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

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This page was last updated on: 4/23/2024