50D2152596 CLIA NUMBER - PINE FAMILY PRACTICE LLC

Laboratory Demographics

  • CLIA Code: 50D2152596
  • Facility Name: PINE FAMILY PRACTICE LLC
  • Facility Address: 2240 E LINCOLN AVE
    SUNNYSIDE, WA
    ZIP 98944
  • Facility Phone: (509) 836-2367
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARY L. PINE
  • NPI Number: 1205393287
  • Taxonomy: 363A00000X - Physician Assistant

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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 5098362367
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/13/2018
Certificate Expiration Date 4/4/2028
Facility Type Physician Office
Lab Director MARY L. PINE

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This page was last updated on: 5/18/2026