Active NPI
Certified Lab Services
- Clinical Medical Laboratory
- Seattle, WA
National Provider Identifier
1568068609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- CERTIFIED LAB SERVICES
- Practice address
- 3123 Fairview Ave E Ste 200
Seattle, WA 98102-3051 - Phone
- (480) 685-7530
- Fax
- (480) 900-8853
- NPI assigned
- Dec 4, 2020
- 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
- Jennifer A Wallace, MEDICAL ASSISTANT
- Title
- Owner/ Operator
- Phone
- (480) 685-7530
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 8
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | |||
| Public Health or Welfare Agency | 251K00000X | |||
| In Home Supportive Care Agency | 253Z00000X | |||
| Community Health Clinic/Center | 261QC1500X | |||
| Medical Specialty Clinic/Center | 261QM2500X | |||
| Clinical Medical Laboratory | 291U00000X | Primary | ||
| Point of Service | 305S00000X | |||
| Assisted Living Facility | 310400000X |
Addresses
Primary practice location
3123 Fairview Ave E Ste 200
Seattle, WA 98102-3051
Mailing address
3123 Fairview Ave E Ste 200
Seattle, WA 98102-3051
Phone (480) 685-7530
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03D2197602 | Other | AZ | US DEPT OF HEALTH AND HUMAN SERVICES |
| PC61547365 | Other | WA | PHLEBOTOMIST LICENSE |
Other names 1
- Certified Lab Services
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Certifiedlabservices@gmail.com | Health Information Exchange (HIE) |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Phlebology Physician
- Mesa, AZ
- NPI 1477282416
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607040000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1779148800000",
"number": "1568068609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3123 FAIRVIEW AVE E STE 200",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981023051",
"telephone_number": "480-685-7530",
"fax_number": "480-900-8853"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3123 FAIRVIEW AVE E STE 200",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981023051",
"telephone_number": "480-685-7530",
"fax_number": "480-900-8853"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CERTIFIED LAB SERVICES",
"organizational_subpart": "NO",
"enumeration_date": "2020-12-04",
"last_updated": "2026-05-19",
"certification_date": "2026-05-19",
"status": "A",
"authorized_official_last_name": "WALLACE",
"authorized_official_first_name": "JENNIFER",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "OWNER/ OPERATOR",
"authorized_official_telephone_number": "480-685-7530",
"authorized_official_credential": "MEDICAL ASSISTANT"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "251K00000X",
"taxonomy_group": "",
"desc": "Public Health or Welfare",
"state": null,
"license": null,
"primary": false
},
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QC1500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Community Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QM2500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Medical Specialty",
"state": null,
"license": null,
"primary": false
},
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": true
},
{
"code": "305S00000X",
"taxonomy_group": "",
"desc": "Point of Service",
"state": null,
"license": null,
"primary": false
},
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "US DEPT OF HEALTH AND HUMAN SERVICES",
"identifier": "03D2197602",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHLEBOTOMIST LICENSE",
"identifier": "PC61547365",
"state": "WA"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Certifiedlabservices@gmail.com",
"affiliation": "N",
"endpointDescription": "business email",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "2041 E 3rd Dr",
"city": "Mesa",
"state": "AZ",
"country_code": "US",
"postal_code": "852041401",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "Certified Lab Services",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.