50D2112997 CLIA NUMBER - BATTLE GROUND MEDICAL OFFICE

Laboratory Demographics

  • CLIA Code: 50D2112997
  • Facility Name: BATTLE GROUND MEDICAL OFFICE
  • Facility Address: 720 W MAIN ST, STE 115
    BATTLE GROUND, WA
    ZIP 98604
  • Facility Phone: 360 687-6515
  • Facility Type: Other - CLINIC
  • Facility Type: Waiver
  • Lab Director: REVA RICKETTS-LORIAUX
  • NPI Number: 1164713368
  • Taxonomy: 111N00000X - Chiropractor

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CLIA Record

Field Name Field Value
CLIA Number 50D2112997
LAB Type Other - CLINIC
Facility Name BATTLE GROUND MEDICAL OFFICE
Street 720 W MAIN ST, STE 115
City BATTLE GROUND
State WA
ZIP 98604
Phone 360 687-6515
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/1/2022
Certificate Expiration Date 4/4/2028
Facility Type Other - CLINIC
Lab Director REVA RICKETTS-LORIAUX

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