50D2019544 CLIA NUMBER - SULLIVAN PARK ASSISTED LIVING COMMUNITY

Laboratory Demographics

  • CLIA Code: 50D2019544
  • Facility Name: SULLIVAN PARK ASSISTED LIVING COMMUNITY
  • Facility Address: 421 S ADAMS RD
    SPOKANE VALLEY, WA
    ZIP 99216
  • Facility Phone: 509 924-5555
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: JUSTIN GRAFF
  • NPI Number: 1154948065
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 50D2019544
LAB Type Assisted Living Facility
Facility Name SULLIVAN PARK ASSISTED LIVING COMMUNITY
Street 421 S ADAMS RD
City SPOKANE VALLEY
State WA
ZIP 99216
Phone 509 924-5555
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/1/2011
Certificate Expiration Date 4/4/2028
Facility Type Assisted Living Facility
Lab Director JUSTIN GRAFF

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