50D2160679 CLIA NUMBER - LEWIS AND CLARK DENTAL

Laboratory Demographics

  • CLIA Code: 50D2160679
  • Facility Name: LEWIS AND CLARK DENTAL
  • Facility Address: 844 6TH ST
    CLARKSTON, WA
    ZIP 99403
  • Facility Phone: 509 444-8888
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: AMY LARSON
  • NPI Number: 1427379460
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 50D2160679
LAB Type Federally Qualified Health Center
Facility Name LEWIS AND CLARK DENTAL
Street 844 6TH ST
City CLARKSTON
State WA
ZIP 99403
Phone 509 444-8888
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/28/2021
Certificate Expiration Date 4/4/2028
Facility Type Federally Qualified Health Center
Lab Director AMY LARSON

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This page was last updated on: 6/4/2025