50D2254859 CLIA NUMBER - PARK VISTA RETIREMENT AND ASSISTED LIVING COMMUNITY

Laboratory Demographics

CLIA Number: 50D2254859

Facility Name: PARK VISTA RETIREMENT AND ASSISTED LIVING COMMUNITY

Facility Address:
2944 SE LUND AVE
PORT ORCHARD, WA
ZIP 98366
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Facility Phone Number: 360 871-2323

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1275746414

Taxonomy: 305S00000X - Point of Service
This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost.

CLIA Record

Field Name	Field Value
CLIA Number	50D2254859
LAB Type	Assisted Living Facility
Facility Name	PARK VISTA RETIREMENT AND ASSISTED LIVING COMMUNITY
Street	2944 SE LUND AVE
City	PORT ORCHARD
State	WA
ZIP	98366
Phone	360 871-2323
CertificateType	4
CertificateEffectiveDate	3/8/2022
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

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