50D2170243 CLIA NUMBER - THERAPEUTIC HEALTH SERVICES - EASTSIDE BRANCH

Laboratory Demographics

CLIA Number: 50D2170243

Facility Name: THERAPEUTIC HEALTH SERVICES - EASTSIDE BRANCH

Facility Address:
1412 140TH PL NE
BELLEVUE, WA
ZIP 98007
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Facility Phone Number: 425 747-7892

Facility Type: Other - DRUG TREATMENT

Certificate Type: Waiver

NPI Number: 1730250259

Taxonomy: 261QM2800X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.

CLIA Record

Field Name	Field Value
CLIA Number	50D2170243
LAB Type	Other - DRUG TREATMENT
Facility Name	THERAPEUTIC HEALTH SERVICES - EASTSIDE BRANCH
Street	1412 140TH PL NE
City	BELLEVUE
State	WA
ZIP	98007
Phone	425 747-7892
CertificateType	4
CertificateEffectiveDate	8/6/2019
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

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