50D2172588 CLIA NUMBER - EVERGREEN EYE CENTER

Laboratory Demographics

  • CLIA Code: 50D2172588
  • Facility Name: EVERGREEN EYE CENTER
  • Facility Address: 502 S M ST
    TACOMA, WA
    ZIP 98405
  • Facility Phone: 800 340-3595
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BRICE NICHOLSON
  • NPI Number: 1346319852
  • Taxonomy: 207W00000X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 50D2172588
LAB Type Physician Office
Facility Name EVERGREEN EYE CENTER
Street 502 S M ST
City TACOMA
State WA
ZIP 98405
Phone 800 340-3595
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/25/2019
Certificate Expiration Date 4/4/2028
Facility Type Physician Office
Lab Director BRICE NICHOLSON

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