50D2265850 CLIA NUMBER - UROLOGY SURGERY CENTER NORTHWEST

Laboratory Demographics

CLIA Number: 50D2265850

Facility Name: UROLOGY SURGERY CENTER NORTHWEST

Facility Address:
1401 E TRENT AVE STE 100
SPOKANE, WA
ZIP 99202
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Facility Phone Number: 509 747-3147

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1457087926

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	50D2265850
LAB Type	Ambulatory Surgery Center
Facility Name	UROLOGY SURGERY CENTER NORTHWEST
Street	1401 E TRENT AVE STE 100
City	SPOKANE
State	WA
ZIP	99202
Phone	509 747-3147
CertificateType	4
CertificateEffectiveDate	8/2/2022
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

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