50D2169168 CLIA NUMBER - BROOKDALE MONTCLAIR POULSBO

Laboratory Demographics

CLIA Number: 50D2169168

Facility Name: BROOKDALE MONTCLAIR POULSBO

Facility Address:
1250 NE LINCOLN RD
POULSBO, WA
ZIP 98370
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Facility Phone Number: 360 697-2223

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1831403377

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	50D2169168
LAB Type	Assisted Living Facility
Facility Name	BROOKDALE MONTCLAIR POULSBO
Street	1250 NE LINCOLN RD
City	POULSBO
State	WA
ZIP	98370
Phone	360 697-2223
CertificateType	4
CertificateEffectiveDate	7/16/2019
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

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