50D2241594 CLIA NUMBER - OPTUM MEDICAL SERVICES PC

Laboratory Demographics

  • CLIA Code: 50D2241594
  • Facility Name: OPTUM MEDICAL SERVICES PC
  • Facility Address: 1111 3RD AVENUE, SUITE 1100
    SEATTLE, WA
    ZIP 98101
  • Facility Phone: 952 205-0628
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RONALD J. SHUMACHER
  • NPI Number: 1124494273
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 50D2241594
LAB Type Physician Office
Facility Name OPTUM MEDICAL SERVICES PC
Street 1111 3RD AVENUE, SUITE 1100
City SEATTLE
State WA
ZIP 98101
Phone 952 205-0628
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/29/2021
Certificate Expiration Date 4/4/2028
Facility Type Physician Office
Lab Director RONALD J. SHUMACHER

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