50D0675692 CLIA NUMBER - PROVIDENCE MOTHER JOSEPH CARE CENTER

Laboratory Demographics

  • CLIA Code: 50D0675692
  • Facility Name: PROVIDENCE MOTHER JOSEPH CARE CENTER
  • Facility Address: 3333 ENSIGN ROAD NE
    OLYMPIA, WA
    ZIP 98506
  • Facility Phone: 360 493-4900
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: RACHEL ERICKSON
  • NPI Number: 1992704126
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 50D0675692
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PROVIDENCE MOTHER JOSEPH CARE CENTER
Street 3333 ENSIGN ROAD NE
City OLYMPIA
State WA
ZIP 98506
Phone 360 493-4900
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 RACHEL ERICKSON

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This page was last updated on: 3/20/2025