50D2266829 CLIA NUMBER - EATONVILLE INTEGRATIVE MEDICINE PS

Laboratory Demographics

  • CLIA Code: 50D2266829
  • Facility Name: EATONVILLE INTEGRATIVE MEDICINE PS
  • Facility Address: 320 CENTER ST E STE 2B
    EATONVILLE, WA
    ZIP 98328
  • Facility Phone: 360 832-2222
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MELISSA BRONOSKE
  • NPI Number: 1962137125
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 50D2266829
LAB Type Physician Office
Facility Name EATONVILLE INTEGRATIVE MEDICINE PS
Street 320 CENTER ST E STE 2B
City EATONVILLE
State WA
ZIP 98328
Phone 360 832-2222
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/16/2022
Certificate Expiration Date 4/4/2028
Facility Type Physician Office
Lab Director MELISSA BRONOSKE

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