50D2168169 CLIA NUMBER - THE VANCOUVER CLINIC - RIDGEFIELD

Laboratory Demographics

CLIA Number: 50D2168169

Facility Name: THE VANCOUVER CLINIC - RIDGEFIELD

Facility Address:
5515 PIONEER ST
RIDGEFIELD, WA
ZIP 98642
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Facility Phone Number: 360 882-2778

Facility Type: Community Clinic

Certificate Type: Certificate of Compliance

NPI Number: 1760004477

Taxonomy: 332H00000X - Eyewear Supplier
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

CLIA Record

Field Name	Field Value
CLIA Number	50D2168169
LAB Type	Community Clinic
Facility Name	THE VANCOUVER CLINIC - RIDGEFIELD
Street	5515 PIONEER ST
City	RIDGEFIELD
State	WA
ZIP	98642
Phone	360 882-2778
CertificateType	2
CertificateEffectiveDate	6/24/2019
CertificateExpirationDate	4/4/2028
FacilityType	Compliance

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