50D2160933 CLIA NUMBER - LOURDES INTERNAL MEDICINE AND PRIMARY CARE

Laboratory Demographics

CLIA Number: 50D2160933

Facility Name: LOURDES INTERNAL MEDICINE AND PRIMARY CARE

Facility Address:
7425 WRIGLEY DR STE 101
PASCO, WA
ZIP 99301
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Facility Phone Number: 509 416-8899

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1053775841

Taxonomy: 284300000X - Special Hospital
A designation by the AHA of a hospital whose primary function of the institution is to provide diagnostic and treatment services for patients who have specified medical conditions, both surgical and nonsurgical.

CLIA Record

Field Name	Field Value
CLIA Number	50D2160933
LAB Type	Physician Office
Facility Name	LOURDES INTERNAL MEDICINE AND PRIMARY CARE
Street	7425 WRIGLEY DR STE 101
City	PASCO
State	WA
ZIP	99301
Phone	509 416-8899
CertificateType	4
CertificateEffectiveDate	1/22/2019
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

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