50D2301990 CLIA NUMBER - COWLITZ INDIAN TRIBE BEHAVIORAL HEALTH SERVICES

Laboratory Demographics

  • CLIA Code: 50D2301990
  • Facility Name: COWLITZ INDIAN TRIBE BEHAVIORAL HEALTH SERVICES
  • Facility Address: 1000 DAVIS PL
    DUPONT, WA
    ZIP 98327
  • Facility Phone: 360 946-2423
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: AMOS CHEN
  • NPI Number: 1770166365
  • Taxonomy: 2083P0901X - Preventive Medicine

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CLIA Record

Field Name Field Value
CLIA Number 50D2301990
LAB Type Mobile Laboratory
Facility Name COWLITZ INDIAN TRIBE BEHAVIORAL HEALTH SERVICES
Street 1000 DAVIS PL
City DUPONT
State WA
ZIP 98327
Phone 360 946-2423
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/3/2024
Certificate Expiration Date 4/4/2028
Facility Type Mobile Laboratory
Lab Director AMOS CHEN

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