50D2310267 CLIA NUMBER - LIGHTHOUSE PEDIATRICS

Laboratory Demographics

  • CLIA Code: 50D2310267
  • Facility Name: LIGHTHOUSE PEDIATRICS
  • Facility Address: 1505 NW GILMAN BLVD STE 8
    ISSAQUAH, WA
    ZIP 98027
  • Facility Phone: 425 243-3599
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SUNG PARK
  • NPI Number: 1336967611
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 50D2310267
LAB Type Physician Office
Facility Name LIGHTHOUSE PEDIATRICS
Street 1505 NW GILMAN BLVD STE 8
City ISSAQUAH
State WA
ZIP 98027
Phone 425 243-3599
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/29/2024
Certificate Expiration Date 4/4/2028
Facility Type Physician Office
Lab Director SUNG PARK

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