50D2126754 CLIA NUMBER - COWLITZ INDIAN TRIBAL HEALTH CLINIC

Laboratory Demographics

  • CLIA Code: 50D2126754
  • Facility Name: COWLITZ INDIAN TRIBAL HEALTH CLINIC
  • Facility Address: 1044 11TH AVE
    LONGVIEW, WA
    ZIP 98632
  • Facility Phone: 360 575-8275
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: LYNELLE NOISY HAWK
  • NPI Number: 1346465101
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 50D2126754
LAB Type Physician Office
Facility Name COWLITZ INDIAN TRIBAL HEALTH CLINIC
Street 1044 11TH AVE
City LONGVIEW
State WA
ZIP 98632
Phone 360 575-8275
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 3/3/2017
Certificate Expiration Date 4/4/2028
Facility Type Physician Office
Lab Director LYNELLE NOISY HAWK

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