50D2267283 CLIA NUMBER - LAKE ASPEN HOME TRAINING TOTAL RENAL CARE INC

Laboratory Demographics

  • CLIA Code: 50D2267283
  • Facility Name: LAKE ASPEN HOME TRAINING TOTAL RENAL CARE INC
  • Facility Address: 1330 N 16TH AVE
    YAKIMA, WA
    ZIP 98902
  • Facility Phone: 509 517-6874
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: NAVEEN RAVIKUMAR
  • NPI Number: 1477822377
  • Taxonomy: 261QM0850X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 50D2267283
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name LAKE ASPEN HOME TRAINING TOTAL RENAL CARE INC
Street 1330 N 16TH AVE
City YAKIMA
State WA
ZIP 98902
Phone 509 517-6874
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/23/2022
Certificate Expiration Date 4/4/2028
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director NAVEEN RAVIKUMAR

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This page was last updated on: 9/29/2025