50D2112791 CLIA NUMBER - NOURISH WELLNESS

Laboratory Demographics

  • CLIA Code: 50D2112791
  • Facility Name: NOURISH WELLNESS
  • Facility Address: 1111 N 35TH AVE STE 120
    YAKIMA, WA
    ZIP 98902
  • Facility Phone: 509 969-6214
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SUSY JIMENEZ
  • NPI Number: 1003321480
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 50D2112791
LAB Type Physician Office
Facility Name NOURISH WELLNESS
Street 1111 N 35TH AVE STE 120
City YAKIMA
State WA
ZIP 98902
Phone 509 969-6214
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/9/2016
Certificate Expiration Date 4/4/2028
Facility Type Physician Office
Lab Director SUSY JIMENEZ

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