50D2255966 CLIA NUMBER - FISHERS LANDING PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 50D2255966
  • Facility Name: FISHERS LANDING PRIMARY CARE
  • Facility Address: 406 SE 164TH AVE STE C305
    VANCOUVER, WA
    ZIP 98683
  • Facility Phone: 360 816-0277
  • Facility Type: Other - NP OFFICE
  • Facility Type: Waiver
  • Lab Director: KATHERINE MOON
  • NPI Number: 1275295164
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 50D2255966
LAB Type Other - NP OFFICE
Facility Name FISHERS LANDING PRIMARY CARE
Street 406 SE 164TH AVE STE C305
City VANCOUVER
State WA
ZIP 98683
Phone 360 816-0277
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/18/2022
Certificate Expiration Date 4/4/2028
Facility Type Other - NP OFFICE
Lab Director KATHERINE MOON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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