50D2113058 CLIA NUMBER - LEGACY SALMON CREEK CHILDREN'S CENTER

Laboratory Demographics

  • CLIA Code: 50D2113058
  • Facility Name: LEGACY SALMON CREEK CHILDREN'S CENTER
  • Facility Address: 2121 NE 139TH ST STE 200 AND 210
    VANCOUVER, WA
    ZIP 98686
  • Facility Phone: 360 487-1778
  • Facility Type: Other - CLINIC
  • Facility Type: Microscopy
  • Lab Director: GIA OH
  • NPI Number: 1841737699
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 50D2113058
LAB Type Other - CLINIC
Facility Name LEGACY SALMON CREEK CHILDREN'S CENTER
Street 2121 NE 139TH ST STE 200 AND 210
City VANCOUVER
State WA
ZIP 98686
Phone 360 487-1778
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/5/2019
Certificate Expiration Date 4/4/2028
Facility Type Other - CLINIC
Lab Director GIA OH

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