50D2189443 CLIA NUMBER - NORTHWEST PEDIATRIC CENTER

Laboratory Demographics

  • CLIA Code: 50D2189443
  • Facility Name: NORTHWEST PEDIATRIC CENTER
  • Facility Address: 1907 COOKS HILL RD
    CENTRALIA, WA
    ZIP 98531
  • Facility Phone: 360 736-6778
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: JENNIFER POLLEY
  • NPI Number: 1518034180
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 50D2189443
LAB Type Rural Health Clinic
Facility Name NORTHWEST PEDIATRIC CENTER
Street 1907 COOKS HILL RD
City CENTRALIA
State WA
ZIP 98531
Phone 360 736-6778
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/30/2020
Certificate Expiration Date 4/4/2028
Facility Type Rural Health Clinic
Lab Director JENNIFER POLLEY

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This page was last updated on: 6/4/2025