50D2218570 CLIA NUMBER - LACEY DIALYSIS

Laboratory Demographics

  • CLIA Code: 50D2218570
  • Facility Name: LACEY DIALYSIS
  • Facility Address: 5200 YELM HWY SE
    LACEY, WA
    ZIP 98503
  • Facility Phone: (564) 464-7847
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: YOUNG HO KIM
  • NPI Number: 1346827284
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 50D2218570
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name LACEY DIALYSIS
Street 5200 YELM HWY SE
City LACEY
State WA
ZIP 98503
Phone 5644647847
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/29/2021
Certificate Expiration Date 4/4/2028
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director YOUNG HO KIM

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This page was last updated on: 5/18/2026