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

Laboratory Demographics

CLIA Number: 50D2267283

Facility Name: LAKE ASPEN HOME TRAINING TOTAL RENAL CARE INC

Facility Address:
1330 N 16TH AVE
YAKIMA, WA
ZIP 98902
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Facility Phone Number: 509 517-6874

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1477822377

Taxonomy: 261QM0850X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.

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
CertificateType	4
CertificateEffectiveDate	8/23/2022
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

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