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50D2292791 CLIA NUMBER - CONCERNED CITIZENS

Laboratory Demographics

CLIA Number: 50D2292791

Facility Name: CONCERNED CITIZENS

Facility Address:
87 SPORTSMAN CLUB RD
FORKS, WA
ZIP 98331
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Facility Phone Number: 360 374-9340

Facility Type: Other - AFH

Certificate Type: Waiver
NPI Number: 1841447752

Taxonomy: 251E00000X - Home Health
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

CLIA Record

Field Name Field Value
CLIA Number 50D2292791
LAB Type Other - AFH
Facility Name CONCERNED CITIZENS
Street 87 SPORTSMAN CLUB RD
City FORKS
State WA
ZIP 98331
Phone 360 374-9340
CertificateType 4
CertificateEffectiveDate 10/30/2023
CertificateExpirationDate 4/4/2028
FacilityType Waiver

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