50D2160483 CLIA NUMBER - MAPLE STREET CLINIC

Laboratory Demographics

  • CLIA Code: 50D2160483
  • Facility Name: MAPLE STREET CLINIC
  • Facility Address: 3919 N MAPLE ST
    SPOKANE, WA
    ZIP 99205
  • Facility Phone: (509) 444-8200
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: TODD SMITH
  • NPI Number: 1245430511
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 50D2160483
LAB Type Federally Qualified Health Center
Facility Name MAPLE STREET CLINIC
Street 3919 N MAPLE ST
City SPOKANE
State WA
ZIP 99205
Phone 5094448200
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 1/11/2019
Certificate Expiration Date 4/4/2028
Facility Type Federally Qualified Health Center
Lab Director TODD SMITH

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