50D2229520 CLIA NUMBER - SEATTLE THEATRE GROUP

Laboratory Demographics

CLIA Number: 50D2229520

Facility Name: SEATTLE THEATRE GROUP

Facility Address:
2509 EVERETT AVE E
SEATTLE, WA
ZIP 98102
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Facility Phone Number: 206 467-5510

Facility Type: Other - THEATRE

Certificate Type: Waiver

NPI Number: 1306388079

Taxonomy: 101YM0800X - Counselor

CLIA Record

Field Name	Field Value
CLIA Number	50D2229520
LAB Type	Other - THEATRE
Facility Name	SEATTLE THEATRE GROUP
Street	2509 EVERETT AVE E
City	SEATTLE
State	WA
ZIP	98102
Phone	206 467-5510
CertificateType	4
CertificateEffectiveDate	7/13/2021
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

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