50D2122657 CLIA NUMBER - CORLISS OPTOMETRISTS

Laboratory Demographics

  • CLIA Code: 50D2122657
  • Facility Name: CORLISS OPTOMETRISTS
  • Facility Address: 312 4TH ST SE
    PUYALLUP, WA
    ZIP 98372
  • Facility Phone: 253 845-0585
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KENNETH J. CORLISS
  • NPI Number: 1932321296
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 50D2122657
LAB Type Physician Office
Facility Name CORLISS OPTOMETRISTS
Street 312 4TH ST SE
City PUYALLUP
State WA
ZIP 98372
Phone 253 845-0585
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/2/2016
Certificate Expiration Date 4/4/2028
Facility Type Physician Office
Lab Director KENNETH J. CORLISS

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