50D2116270 CLIA NUMBER - OVERLAKE MEDICAL CLINIC LAKE HILLS URGENT CARE

Laboratory Demographics

CLIA Number: 50D2116270

Facility Name: OVERLAKE MEDICAL CLINIC LAKE HILLS URGENT CARE

Facility Address:
619 156TH AVE SE
BELLEVUE, WA
ZIP 98007
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Facility Phone Number: 425 637-3280

Facility Type: Other - CLINIC

Certificate Type: Certificate of Compliance

NPI Number: 1770580086

Taxonomy: 261QS0132X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	50D2116270
LAB Type	Other - CLINIC
Facility Name	OVERLAKE MEDICAL CLINIC LAKE HILLS URGENT CARE
Street	619 156TH AVE SE
City	BELLEVUE
State	WA
ZIP	98007
Phone	425 637-3280
CertificateType	2
CertificateEffectiveDate	7/22/2016
CertificateExpirationDate	4/4/2028
FacilityType	Compliance

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