Active NPI
Saint Clare Hospital
Doing business as Paclab
- Clinical Medical Laboratory
- Lakewood, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- SAINT CLARE HOSPITAL
- Doing business as
- Paclab
- Practice address
- 11315 Bridgeport Way SE
Lakewood, WA 98499-3004 - Phone
- (800) 752-8994
- NPI assigned
- May 8, 2007
- Last updated
- Apr 21, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Kurt Rogers
- Title
- Cfo
- Phone
- (509) 755-8700
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Primary |
Addresses
Primary practice location
11315 Bridgeport Way SE
Lakewood, WA 98499-3004
Mailing address
PO Box 2670
Spokane, WA 99220-2670
Phone (800) 752-8994
Other names 1
- PACLAB
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110606000169 | WA | Part A Provider - Hospital | 4981593563 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Lakewood, WA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1003029745. Details of each certification follow.
Hospital certification: CCN 500021
- Legal name
- SAINT CLARE HOSPITAL
- Doing business as
- ST CLARE HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1966
- Last certification
- Jul 8, 1993
- Beds
- 105
- Ownership / control type
- Church
- Organization structure
- Corporation
- Enrollment address
- 11315 Bridgeport Way SW
Lakewood, WA 98499-3004 - Hospital subgroups
- Acute care
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba ST. Clare Hospital
- General Acute Care Hospital
- Lakewood, WA
- NPI 1689672693
O20110606000169
Care Compare: Hospital
Medicare Care Compare- Listed as
- St Clare Hospital
- Overall star rating
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Church
- Medicare certification status
- Active
- Emergency services
- Yes
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 50D0719713 | St Clare Hospital Laboratory | Accreditation | Apr 4, 2028 |
| 50D0978628 | FHS St Clare Hospital Poct | Compliance | Apr 4, 2028 |
National Provider Directory
National Provider Directory- Tax ID family
- St Clare Hosp
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
dba St Clare Hospital
- General Acute Care Hospital
- Lakewood, WA
- NPI 1407263817
Locations
11311 Bridgeport Way SW
Ste 102
Lakewood, WA 98499
11311 Bridgeport Way SW
Ste 304
Tacoma, WA 98499
Phone (253) 426-6753
Ownership & related parties
All disclosed owners & managing parties 18
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Robert Carlile | Corporate Director | Jan 1, 2021 | |
| Diann E Puls | Corporate Director | Jul 1, 2011 | |
| Marvin O'Quinn | Corporate Director | Jan 1, 2021 | |
| Uli Han-Hsiang CHI | Corporate Director | Apr 1, 2013 | |
| Commonspirit Health | 5% Or Greater Direct Ownership Interest | Jan 1, 2011 | |
| Gregg S Meyer | Corporate Director | Jan 1, 2021 | |
| Franciscan Health System | 5% Or Greater Direct Ownership Interest | Jan 1, 2011 | |
| Operational/Managerial Control | Jan 1, 2011 | ||
| Robert Lemon | Corporate Director | Jan 1, 2021 | |
| David Nosacka | Corporate Officer | Jul 5, 2021 | |
| W-2 Managing Employee | Jul 5, 2021 | ||
| Karen T Lee | Corporate Director | Jan 1, 2021 | |
| John F Oppenheimer | Corporate Director | Jan 1, 2021 | |
| David Butcherite | W-2 Managing Employee | Jul 1, 2004 | |
| Carolyn Corvi | Corporate Director | Jan 1, 2021 | |
| Ketul J Patel | W-2 Managing Employee | Feb 23, 2015 | |
| Michael a Hoffman | Corporate Director | Jul 1, 2012 | |
| Ruth Elizabeth Goodwin | Corporate Director | Jul 1, 2020 | |
| Dennis Joseph Hunthausen | Corporate Director | Jul 1, 2012 | |
| Tod Hamachek | Corporate Director | Jan 1, 2021 |
Owners & managing parties with NPI records 7
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
dba Franciscan Pharmacy Tacoma
- Community/Retail Pharmacy
- Tacoma, WA
- NPI 1346588548
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Franciscan Hospice and Palliative Care
- Community Based Hospice Care Agency
- University Place, WA
- NPI 1366472508
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba St Joseph Cardiothoracic Surgeons
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Gig Harbor, WA
- NPI 1821363300
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Franciscan Pharmacy and Home Medical Supply St. Joseph
- Durable Medical Equipment & Medical Supplies
- Tacoma, WA
- NPI 1902986904
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba St Joseph Medical Center
- General Acute Care Hospital
- Tacoma, WA
- NPI 1952309098
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Palliative Medical Services
- Internal Medicine Physician
- Tacoma, WA
- NPI 1972538312
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
Practitioners & affiliated clinicians
Affiliated clinicians 417
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Hospitalist Physician
- Federal Way, WA
- NPI 1265524961
-
- Hospitalist Physician
- Lakewood, WA
- NPI 1578593703
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178582400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1303344000000",
"number": "1003029745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2670",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992202670",
"telephone_number": "800-752-8994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11315 BRIDGEPORT WAY SE",
"city": "LAKEWOOD",
"state": "WA",
"postal_code": "984993004",
"telephone_number": "800-752-8994"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SAINT CLARE HOSPITAL",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-08",
"last_updated": "2011-04-21",
"status": "A",
"authorized_official_last_name": "ROGERS",
"authorized_official_first_name": "KURT",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "509-755-8700",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "PACLAB",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Lakewood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.