50D2294720 CLIA NUMBER - HERITAGE CLINIC

Laboratory Demographics

CLIA Number: 50D2294720

Facility Name: HERITAGE CLINIC

Facility Address:
1129 S 2ND AVE STE B
WALLA WALLA, WA
ZIP 99362
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Facility Phone Number: 509 520-5520

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1669153045

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	50D2294720
LAB Type	Community Clinic
Facility Name	HERITAGE CLINIC
Street	1129 S 2ND AVE STE B
City	WALLA WALLA
State	WA
ZIP	99362
Phone	509 520-5520
CertificateType	4
CertificateEffectiveDate	11/29/2023
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

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