50D2170241 CLIA NUMBER - IN KWON PARK INTERNAL MEDICINE INFECTIOUS DISEASES

Laboratory Demographics

  • CLIA Code: 50D2170241
  • Facility Name: IN KWON PARK INTERNAL MEDICINE INFECTIOUS DISEASES
  • Facility Address: 8730 S TACOMA STE 104
    LAKEWOOD, WA
    ZIP 98499
  • Facility Phone: 253 212-3637
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: IN KWON PARK
  • NPI Number: 1417509746
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 50D2170241
LAB Type Physician Office
Facility Name IN KWON PARK INTERNAL MEDICINE INFECTIOUS DISEASES
Street 8730 S TACOMA STE 104
City LAKEWOOD
State WA
ZIP 98499
Phone 253 212-3637
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/6/2019
Certificate Expiration Date 4/4/2028
Facility Type Physician Office
Lab Director IN KWON PARK

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