104TH AVENUE MEDICAL CLINIC INCORPORATED
NPI 1396921326
Clinic/Center in Kent, WA
About 104th Avenue Medical Clinic Incorporated NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
104TH AVENUE MEDICAL CLINIC INCORPORATED (NPI 1396921326) is a healthcare organization registered as a clinic/center in Kent, Washington and active in the NPI registry since January 2008. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Ranu Choudhary, Vice-president, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
Other Identifiers 3
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 50D0976109
104th Avenue Medical Clinic Inc · Kent, WAOther Providers at the Same Location NPPES 6
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is 104th Avenue Medical Clinic Incorporated's NPI number?
The NPI number for 104th Avenue Medical Clinic Incorporated is 1396921326. It was assigned to this organization in the NPPES registry on January 22, 2008.
Where is 104th Avenue Medical Clinic Incorporated located?
104th Avenue Medical Clinic Incorporated is located at 24604 104th Ave SE # 202, Kent, WA 98030. The listed phone number is (253) 859-8371.
What is 104th Avenue Medical Clinic Incorporated's specialty?
The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.
Does 104th Avenue Medical Clinic Incorporated hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 50D0976109) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for 104th Avenue Medical Clinic Incorporated was last updated on October 1, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.
