50D0718117 CLIA NUMBER - OTHELLO POST ACUTE

Laboratory Demographics

  • CLIA Code: 50D0718117
  • Facility Name: OTHELLO POST ACUTE
  • Facility Address: 495 N 13TH AVE
    OTHELLO, WA
    ZIP 99344
  • Facility Phone: 509 488-9609
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: BENITA WILSON
  • NPI Number: 1528052891
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 50D0718117
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name OTHELLO POST ACUTE
Street 495 N 13TH AVE
City OTHELLO
State WA
ZIP 99344
Phone 509 488-9609
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 BENITA WILSON

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