50D2190218 CLIA NUMBER - NORTHWEST SURGERY CENTER

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Laboratory Demographics

CLIA Number: 50D2190218

Facility Name: NORTHWEST SURGERY CENTER

Facility Address:
123 W FRANCIS AVE
SPOKANE, WA
ZIP 99205
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Facility Phone Number: 509 483-9363

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1982745568

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	50D2190218
LAB Type	Ambulatory Surgery Center
Facility Name	NORTHWEST SURGERY CENTER
Street	123 W FRANCIS AVE
City	SPOKANE
State	WA
ZIP	99205
Phone	509 483-9363
CertificateType	4
CertificateEffectiveDate	8/11/2020
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

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