50D2257461 CLIA NUMBER - KELLEY-ROSS CAPITOL HILL PHARMACY

Laboratory Demographics

  • CLIA Code: 50D2257461
  • Facility Name: KELLEY-ROSS CAPITOL HILL PHARMACY
  • Facility Address: 400 E PINE ST STE 100B
    SEATTLE, WA
    ZIP 98122
  • Facility Phone: 206 641-7766
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SCOTT HERZOG
  • NPI Number: 1538817143
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2257461
LAB Type Pharmacy
Facility Name KELLEY-ROSS CAPITOL HILL PHARMACY
Street 400 E PINE ST STE 100B
City SEATTLE
State WA
ZIP 98122
Phone 206 641-7766
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/5/2022
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director SCOTT HERZOG

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