50D2148990 CLIA NUMBER - WEST HILL MEDICAL CLINIC

Laboratory Demographics

CLIA Number: 50D2148990

Facility Name: WEST HILL MEDICAL CLINIC

Facility Address:
27115 MILITARY RD S
KENT, WA
ZIP 98032
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Facility Phone Number: 253 850-8750

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1780174706

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	50D2148990
LAB Type	Physician Office
Facility Name	WEST HILL MEDICAL CLINIC
Street	27115 MILITARY RD S
City	KENT
State	WA
ZIP	98032
Phone	253 850-8750
CertificateType	4
CertificateEffectiveDate	5/22/2018
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

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