50D2185299 CLIA NUMBER - RIVER VALLEY COMMUNITY HEALTH

Laboratory Demographics

CLIA Number: 50D2185299

Facility Name: RIVER VALLEY COMMUNITY HEALTH

Facility Address:
424 WILLIAMS ST
MOSSYROCK, WA
ZIP 98564
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Facility Phone Number: 360 983-3589

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1558982413

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	50D2185299
LAB Type	Community Clinic
Facility Name	RIVER VALLEY COMMUNITY HEALTH
Street	424 WILLIAMS ST
City	MOSSYROCK
State	WA
ZIP	98564
Phone	360 983-3589
CertificateType	4
CertificateEffectiveDate	3/31/2022
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

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