50D2108446 CLIA NUMBER - WEST SOUND DERMATOLOGY

Laboratory Demographics

CLIA Number: 50D2108446

Facility Name: WEST SOUND DERMATOLOGY

Facility Address:
19917 7TH AVE NE STE 203 AND 101
POULSBO, WA
ZIP 98370
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Facility Phone Number: 360 824-5474

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1366837650

Taxonomy: 261QR0405X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	50D2108446
LAB Type	Physician Office
Facility Name	WEST SOUND DERMATOLOGY
Street	19917 7TH AVE NE STE 203 AND 101
City	POULSBO
State	WA
ZIP	98370
Phone	360 824-5474
CertificateType	2
CertificateEffectiveDate	2/4/2016
CertificateExpirationDate	4/4/2028
FacilityType	Compliance

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