50D2090749 CLIA NUMBER - CASCADE COMMUNITY HEALTH CARE

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Laboratory Demographics

CLIA Number: 50D2090749

Facility Name: CASCADE COMMUNITY HEALTH CARE

Facility Address:
2428 W REYNOLDS AVE
CENTRALIA, WA
ZIP 98531
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Facility Phone Number: 360 330-9044

Facility Type: Other - COMMUNITY MENTAL HEALTH

Certificate Type: Waiver

NPI Number: 1619068624

Taxonomy: 101YM0800X - Counselor

CLIA Record

Field Name	Field Value
CLIA Number	50D2090749
LAB Type	Other - COMMUNITY MENTAL HEALTH
Facility Name	CASCADE COMMUNITY HEALTH CARE
Street	2428 W REYNOLDS AVE
City	CENTRALIA
State	WA
ZIP	98531
Phone	360 330-9044
CertificateType	4
CertificateEffectiveDate	1/29/2015
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

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This page was last updated on: 4/23/2024