50D2097082 CLIA NUMBER - FIELDSTONE MEMORY CARE OF KENNEWICK

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Laboratory Demographics

CLIA Number: 50D2097082

Facility Name: FIELDSTONE MEMORY CARE OF KENNEWICK

Facility Address:
575 N YOUNG ST
KENNEWICK, WA
ZIP 99336
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Facility Phone Number: 509 491-3945

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1174027114

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	50D2097082
LAB Type	Assisted Living Facility
Facility Name	FIELDSTONE MEMORY CARE OF KENNEWICK
Street	575 N YOUNG ST
City	KENNEWICK
State	WA
ZIP	99336
Phone	509 491-3945
CertificateType	4
CertificateEffectiveDate	6/8/2015
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

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