50D2302769 CLIA NUMBER - PEACEHEALTH MEDICAL GROUP - UROLOGY

Laboratory Demographics

  • CLIA Code: 50D2302769
  • Facility Name: PEACEHEALTH MEDICAL GROUP - UROLOGY
  • Facility Address: 8614 E MILL PLAIN BLVD STE 201
    VANCOUVER, WA
    ZIP 98664
  • Facility Phone: 360 729-8580
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KATIE TRIPPET
  • NPI Number: 1003194911
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 50D2302769
LAB Type Physician Office
Facility Name PEACEHEALTH MEDICAL GROUP - UROLOGY
Street 8614 E MILL PLAIN BLVD STE 201
City VANCOUVER
State WA
ZIP 98664
Phone 360 729-8580
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/16/2024
Certificate Expiration Date 4/4/2028
Facility Type Physician Office
Lab Director KATIE TRIPPET

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