50D2180996 CLIA NUMBER - WALLA WALLA CLINIC DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 50D2180996
  • Facility Name: WALLA WALLA CLINIC DERMATOLOGY
  • Facility Address: 19 SOUTHPOINT LN
    WALLA WALLA, WA
    ZIP 99362
  • Facility Phone: 509 525-3720
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DAVID PANTHER
  • NPI Number: 1124132097
  • Taxonomy: 251300000X - Local Education Agency (LEA)

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CLIA Record

Field Name Field Value
CLIA Number 50D2180996
LAB Type Physician Office
Facility Name WALLA WALLA CLINIC DERMATOLOGY
Street 19 SOUTHPOINT LN
City WALLA WALLA
State WA
ZIP 99362
Phone 509 525-3720
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 3/24/2020
Certificate Expiration Date 4/4/2028
Facility Type Physician Office
Lab Director DAVID PANTHER

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