50D2197876 CLIA NUMBER - OLYMPIA INTEGRATIVE MEDICINE

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Laboratory Demographics

CLIA Number: 50D2197876

Facility Name: OLYMPIA INTEGRATIVE MEDICINE

Facility Address:
2610 YELM HWY SE
OLYMPIA, WA
ZIP 98501
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Facility Phone Number: 360 915-9389

Facility Type: Other - CLINIC

Certificate Type: Waiver

NPI Number: 1518599273

Taxonomy: 207QA0505X - Family Medicine
The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.

CLIA Record

Field Name	Field Value
CLIA Number	50D2197876
LAB Type	Other - CLINIC
Facility Name	OLYMPIA INTEGRATIVE MEDICINE
Street	2610 YELM HWY SE
City	OLYMPIA
State	WA
ZIP	98501
Phone	360 915-9389
CertificateType	4
CertificateEffectiveDate	10/28/2020
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

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