50D2265116 CLIA NUMBER - EVERGREEN HEALTH PRIMARY CARE REDMOND TOWN CENTER

Laboratory Demographics

  • CLIA Code: 50D2265116
  • Facility Name: EVERGREEN HEALTH PRIMARY CARE REDMOND TOWN CENTER
  • Facility Address: 7345 164TH AVE NE STE I105
    REDMOND, WA
    ZIP 98052
  • Facility Phone: 425 522-8312
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PRATIMA SHARMA
  • NPI Number: 1013934918
  • Taxonomy: 231H00000X - Audiologist

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CLIA Record

Field Name Field Value
CLIA Number 50D2265116
LAB Type Physician Office
Facility Name EVERGREEN HEALTH PRIMARY CARE REDMOND TOWN CENTER
Street 7345 164TH AVE NE STE I105
City REDMOND
State WA
ZIP 98052
Phone 425 522-8312
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/22/2022
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