50D2172584 CLIA NUMBER - MULTICARE GOOD SAMARITAN EMERGENCY BONNEY LAKE

Laboratory Demographics

CLIA Number: 50D2172584

Facility Name: MULTICARE GOOD SAMARITAN EMERGENCY BONNEY LAKE

Facility Address:
9550 195TH AVE E
BONNEY LAKE, WA
ZIP 98391
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Facility Phone Number: 253 447-3400

Facility Type: Other - FREE STANDING ED

Certificate Type: Certificate of Compliance

NPI Number: 1497331243

Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

CLIA Record

Field Name	Field Value
CLIA Number	50D2172584
LAB Type	Other - FREE STANDING ED
Facility Name	MULTICARE GOOD SAMARITAN EMERGENCY BONNEY LAKE
Street	9550 195TH AVE E
City	BONNEY LAKE
State	WA
ZIP	98391
Phone	253 447-3400
CertificateType	2
CertificateEffectiveDate	9/25/2019
CertificateExpirationDate	4/4/2028
FacilityType	Compliance

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