50D2228939 CLIA NUMBER - SUMMIT DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 50D2228939
  • Facility Name: SUMMIT DERMATOLOGY
  • Facility Address: 300 LILLY RD NE STE A
    OLYMPIA, WA
    ZIP 98506
  • Facility Phone: 360 918-8101
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JESSICA KIM
  • NPI Number: 1639531445
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 50D2228939
LAB Type Physician Office
Facility Name SUMMIT DERMATOLOGY
Street 300 LILLY RD NE STE A
City OLYMPIA
State WA
ZIP 98506
Phone 360 918-8101
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/2/2021
Certificate Expiration Date 4/4/2028
Facility Type Physician Office
Lab Director JESSICA KIM

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