50D2267109 CLIA NUMBER - PONDEROSA ASSISTED LIVING

Laboratory Demographics

CLIA Number: 50D2267109

Facility Name: PONDEROSA ASSISTED LIVING

Facility Address:
3300 ENGLEWOOD AVE
YAKIMA, WA
ZIP 98902
Get Directions

Facility Phone Number: 509 453-1366

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1407360936

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	50D2267109
LAB Type	Assisted Living Facility
Facility Name	PONDEROSA ASSISTED LIVING
Street	3300 ENGLEWOOD AVE
City	YAKIMA
State	WA
ZIP	98902
Phone	509 453-1366
CertificateType	4
CertificateEffectiveDate	8/19/2022
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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