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50D2152596 CLIA NUMBER - PINE FAMILY PRACTICE LLC

Laboratory Demographics

CLIA Number: 50D2152596

Facility Name: PINE FAMILY PRACTICE LLC

Facility Address:
2240 E LINCOLN AVE
SUNNYSIDE, WA
ZIP 98944
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Facility Phone Number: 509 836-2367

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1770063968

Taxonomy: 363A00000X - Physician Assistant
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

CLIA Record

Field Name Field Value
CLIA Number 50D2152596
LAB Type Physician Office
Facility Name PINE FAMILY PRACTICE LLC
Street 2240 E LINCOLN AVE
City SUNNYSIDE
State WA
ZIP 98944
Phone 509 836-2367
CertificateType 4
CertificateEffectiveDate 8/13/2018
CertificateExpirationDate 4/4/2028
FacilityType Waiver

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