50D0675030 CLIA NUMBER - WILLAPA HARBOR CARE

Laboratory Demographics

  • CLIA Code: 50D0675030
  • Facility Name: WILLAPA HARBOR CARE
  • Facility Address: 1100 JACKSON AVE
    RAYMOND, WA
    ZIP 98577
  • Facility Phone: 360 942-2424
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ERIN B. WIRKKALA
  • NPI Number: 1659365922
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 50D0675030
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name WILLAPA HARBOR CARE
Street 1100 JACKSON AVE
City RAYMOND
State WA
ZIP 98577
Phone 360 942-2424
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 ERIN B. WIRKKALA

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