50D2250642 CLIA NUMBER - FEDERAL WAY

Laboratory Demographics

CLIA Number: 50D2250642

Facility Name: FEDERAL WAY

Facility Address:
33915 1ST WAY S STE 130
FEDERAL WAY, WA
ZIP 98003
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Facility Phone Number: 206 525-1168

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1760936637

Taxonomy: 305R00000X - Preferred Provider Organization
A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level.

CLIA Record

Field Name	Field Value
CLIA Number	50D2250642
LAB Type	Physician Office
Facility Name	FEDERAL WAY
Street	33915 1ST WAY S STE 130
City	FEDERAL WAY
State	WA
ZIP	98003
Phone	206 525-1168
CertificateType	2
CertificateEffectiveDate	1/28/2022
CertificateExpirationDate	4/4/2028
FacilityType	Compliance

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