50D2156199 CLIA NUMBER - BROOKDALE COURTYARD PUYALLUP

Laboratory Demographics

CLIA Number: 50D2156199

Facility Name: BROOKDALE COURTYARD PUYALLUP

Facility Address:
4610 6TH STREET PL SE
PUYALLUP, WA
ZIP 98374
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Facility Phone Number: 253 841-9722

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1821132440

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	50D2156199
LAB Type	Assisted Living Facility
Facility Name	BROOKDALE COURTYARD PUYALLUP
Street	4610 6TH STREET PL SE
City	PUYALLUP
State	WA
ZIP	98374
Phone	253 841-9722
CertificateType	4
CertificateEffectiveDate	10/11/2018
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

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