50D2106535 CLIA NUMBER - SALMON CREEK PLASTIC SURGERY

Laboratory Demographics

  • CLIA Code: 50D2106535
  • Facility Name: SALMON CREEK PLASTIC SURGERY
  • Facility Address: 13712 NE 10TH AVE
    VANCOUVER, WA
    ZIP 98685
  • Facility Phone: 360 823-0860
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: RICHARD K. GREEN
  • NPI Number: 1831253426
  • Taxonomy: 208200000X - Plastic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 50D2106535
LAB Type Ambulatory Surgery Center
Facility Name SALMON CREEK PLASTIC SURGERY
Street 13712 NE 10TH AVE
City VANCOUVER
State WA
ZIP 98685
Phone 360 823-0860
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/21/2015
Certificate Expiration Date 4/4/2028
Facility Type Ambulatory Surgery Center
Lab Director RICHARD K. GREEN

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