50D2119795 CLIA NUMBER - IDEAL OPTION PLLC

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Laboratory Demographics

CLIA Number: 50D2119795

Facility Name: IDEAL OPTION PLLC

Facility Address:
4301 HOYT AVE
EVERETT, WA
ZIP 98203
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Facility Phone Number: 877 522-1275

Facility Type: Other - DRUG TREATMENT

Certificate Type: Waiver

NPI Number: 1457788275

Taxonomy: 2083A0300X - Preventive Medicine
A physician engaged in the subspecialty practice of Addiction Medicine who specializes in the prevention, evaluation, diagnosis, treatment, and recovery of persons with the disease of addiction.

CLIA Record

Field Name	Field Value
CLIA Number	50D2119795
LAB Type	Other - DRUG TREATMENT
Facility Name	IDEAL OPTION PLLC
Street	4301 HOYT AVE
City	EVERETT
State	WA
ZIP	98203
Phone	877 522-1275
CertificateType	4
CertificateEffectiveDate	11/9/2023
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

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