50D0661629 CLIA NUMBER - WASHINGTON ODD FELLOWS HOME

Laboratory Demographics

  • CLIA Code: 50D0661629
  • Facility Name: WASHINGTON ODD FELLOWS HOME
  • Facility Address: 534 BOYER AVENUE
    WALLA WALLA, WA
    ZIP 99362
  • Facility Phone: 509 525-6463
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: JEANETTE BARTHOLOMEW
  • NPI Number: 1114917630
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 50D0661629
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name WASHINGTON ODD FELLOWS HOME
Street 534 BOYER AVENUE
City WALLA WALLA
State WA
ZIP 99362
Phone 509 525-6463
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/1992
Certificate Expiration Date 4/4/2028
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director JEANETTE BARTHOLOMEW

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