50D2329318 CLIA NUMBER - TELLICA IMAGING - WASHINGTON LLC

Laboratory Demographics

  • CLIA Code: 50D2329318
  • Facility Name: TELLICA IMAGING - WASHINGTON LLC
  • Facility Address: 2921 S 38TH STREET
    TACOMA, WA
    ZIP 98409
  • Facility Phone: 253 534-8688
  • Facility Type: Other - DIAGNOSTIC IMAGING FAC
  • Facility Type: Waiver
  • Lab Director: AUSTIN THORNHILL
  • NPI Number: 1346093150
  • Taxonomy: 261QR0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 50D2329318
LAB Type Other - DIAGNOSTIC IMAGING FAC
Facility Name TELLICA IMAGING - WASHINGTON LLC
Street 2921 S 38TH STREET
City TACOMA
State WA
ZIP 98409
Phone 253 534-8688
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/26/2025
Certificate Expiration Date 4/4/2028
Facility Type Other - DIAGNOSTIC IMAGING FAC
Lab Director AUSTIN THORNHILL

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