50D2254876 CLIA NUMBER - EVERGREEN HEALTH PRIMARY CARE - DUVALL

Laboratory Demographics

  • CLIA Code: 50D2254876
  • Facility Name: EVERGREEN HEALTH PRIMARY CARE - DUVALL
  • Facility Address: 14720 MAIN ST NE STE 109
    DUVALL, WA
    ZIP 98019
  • Facility Phone: 425 488-4889
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PRATIMA SHARMA
  • NPI Number: 1700447968
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 50D2254876
LAB Type Physician Office
Facility Name EVERGREEN HEALTH PRIMARY CARE - DUVALL
Street 14720 MAIN ST NE STE 109
City DUVALL
State WA
ZIP 98019
Phone 425 488-4889
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/8/2022
Certificate Expiration Date 4/4/2028
Facility Type Physician Office
Lab Director PRATIMA SHARMA

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