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50D2174778 CLIA NUMBER - NORTHWEST MEDICAL SPECIALTIES

Laboratory Demographics

CLIA Number: 50D2174778

Facility Name: NORTHWEST MEDICAL SPECIALTIES

Facility Address:
2940 S MERIDIAN
PUYALLUP, WA
ZIP 98373
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Facility Phone Number: 253 428-8700

Facility Type: Physician Office

Certificate Type: Certificate of Compliance
NPI Number: 1588052245

Taxonomy: 207RH0003X - Internal Medicine
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

CLIA Record

Field Name Field Value
CLIA Number 50D2174778
LAB Type Physician Office
Facility Name NORTHWEST MEDICAL SPECIALTIES
Street 2940 S MERIDIAN
City PUYALLUP
State WA
ZIP 98373
Phone 253 428-8700
CertificateType 2
CertificateEffectiveDate 12/9/2020
CertificateExpirationDate 4/4/2028
FacilityType Compliance

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