50D2292544 CLIA NUMBER - COWLITZ INDIAN TRIBE BEHAVIORAL HEALTH SERVICES

Laboratory Demographics

  • CLIA Code: 50D2292544
  • Facility Name: COWLITZ INDIAN TRIBE BEHAVIORAL HEALTH SERVICES
  • Facility Address: 900 FIR ST
    LONGVIEW, WA
    ZIP 98632
  • Facility Phone: (360) 353-9422
  • Facility Type: Other - BH OUTPATIENT
  • Facility Type: Waiver
  • Lab Director: JENNIFER FRESH
  • NPI Number: 1619194123
  • Taxonomy: 2083P0901X - Preventive Medicine

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CLIA Record

Field Name Field Value
CLIA Number 50D2292544
LAB Type Other - BH OUTPATIENT
Facility Name COWLITZ INDIAN TRIBE BEHAVIORAL HEALTH SERVICES
Street 900 FIR ST
City LONGVIEW
State WA
ZIP 98632
Phone 3603539422
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/26/2023
Certificate Expiration Date 4/4/2028
Facility Type Other - BH OUTPATIENT
Lab Director JENNIFER FRESH

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This page was last updated on: 5/18/2026