50D1079838 CLIA NUMBER - BLUE MOUNTAIN HEART TO HEART

Laboratory Demographics

  • CLIA Code: 50D1079838
  • Facility Name: BLUE MOUNTAIN HEART TO HEART
  • Facility Address: 1129 S 2ND AVE STE B
    WALLA WALLA, WA
    ZIP 99362
  • Facility Phone: 509 529-4744
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: EVERETT MAROON
  • NPI Number: 1003008046
  • Taxonomy: 251B00000X - Case Management

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CLIA Record

Field Name Field Value
CLIA Number 50D1079838
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name BLUE MOUNTAIN HEART TO HEART
Street 1129 S 2ND AVE STE B
City WALLA WALLA
State WA
ZIP 99362
Phone 509 529-4744
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/7/2008
Certificate Expiration Date 4/4/2028
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director EVERETT MAROON

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