50D2156012 CLIA NUMBER - MT BAKER PAIN CLINIC AND SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 50D2156012
  • Facility Name: MT BAKER PAIN CLINIC AND SURGERY CENTER
  • Facility Address: 4029 NORTHWEST AVE STE 301
    BELLINGHAM, WA
    ZIP 98226
  • Facility Phone: 360 752-0518
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: BRENT RICHARDSON
  • NPI Number: 1013243393
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 50D2156012
LAB Type Ambulatory Surgery Center
Facility Name MT BAKER PAIN CLINIC AND SURGERY CENTER
Street 4029 NORTHWEST AVE STE 301
City BELLINGHAM
State WA
ZIP 98226
Phone 360 752-0518
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/9/2018
Certificate Expiration Date 4/4/2028
Facility Type Ambulatory Surgery Center
Lab Director BRENT RICHARDSON

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