50D2007058 CLIA NUMBER - ST PAUL MEDICAL CLINIC PS

Laboratory Demographics

  • CLIA Code: 50D2007058
  • Facility Name: ST PAUL MEDICAL CLINIC PS
  • Facility Address: 510 6TH AVE S STE 101
    SEATTLE, WA
    ZIP 98104
  • Facility Phone: 206 682-7059
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: TONY PHAM
  • NPI Number: 1265750830
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 50D2007058
LAB Type Physician Office
Facility Name ST PAUL MEDICAL CLINIC PS
Street 510 6TH AVE S STE 101
City SEATTLE
State WA
ZIP 98104
Phone 206 682-7059
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 5/6/2010
Certificate Expiration Date 4/4/2028
Facility Type Physician Office
Lab Director TONY PHAM

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This page was last updated on: 6/4/2025