50D2177044 CLIA NUMBER - HARBOR PEDIATRICS - MARY BRIDGE CHILDREN'S

Laboratory Demographics

  • CLIA Code: 50D2177044
  • Facility Name: HARBOR PEDIATRICS - MARY BRIDGE CHILDREN'S
  • Facility Address: 4700 PT FOSDICK DR NW STE 319
    GIG HARBOR, WA
    ZIP 98335
  • Facility Phone: 253 530-8328
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DENISE M. MICHAELSEN
  • NPI Number: 1083873582
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 50D2177044
LAB Type Physician Office
Facility Name HARBOR PEDIATRICS - MARY BRIDGE CHILDREN'S
Street 4700 PT FOSDICK DR NW STE 319
City GIG HARBOR
State WA
ZIP 98335
Phone 253 530-8328
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/2/2020
Certificate Expiration Date 4/4/2028
Facility Type Physician Office
Lab Director DENISE M. MICHAELSEN

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