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50D2221055 CLIA NUMBER - PROVIDENCE - WSU INTERNAL MEDICINE CENTER

Laboratory Demographics

CLIA Number: 50D2221055

Facility Name: PROVIDENCE - WSU INTERNAL MEDICINE CENTER

Facility Address:
1321 COLBY AVE #B400
EVERETT, WA
ZIP 98201
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Facility Phone Number: 425 297-5234

Facility Type: Community Clinic

Certificate Type: Waiver
NPI Number: 1609800861

Taxonomy: 207R00000X - Internal Medicine
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

CLIA Record

Field Name Field Value
CLIA Number 50D2221055
LAB Type Community Clinic
Facility Name PROVIDENCE - WSU INTERNAL MEDICINE CENTER
Street 1321 COLBY AVE #B400
City EVERETT
State WA
ZIP 98201
Phone 425 297-5234
CertificateType 4
CertificateEffectiveDate 4/16/2021
CertificateExpirationDate 4/4/2028
FacilityType Waiver

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