50D2306421 CLIA NUMBER - NORTHWEST ROYAL HOME CARE, LLC

Laboratory Demographics

  • CLIA Code: 50D2306421
  • Facility Name: NORTHWEST ROYAL HOME CARE, LLC
  • Facility Address: 7029 NE FAIRWAY AVE
    VANCOUVER, WA
    ZIP 98662
  • Facility Phone: 360 524-5653
  • Facility Type: Other - AFH
  • Facility Type: Waiver
  • Lab Director: ALLA POLYAKOV
  • NPI Number: 1982067591
  • Taxonomy: 311ZA0620X - Custodial Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 50D2306421
LAB Type Other - AFH
Facility Name NORTHWEST ROYAL HOME CARE, LLC
Street 7029 NE FAIRWAY AVE
City VANCOUVER
State WA
ZIP 98662
Phone 360 524-5653
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/17/2024
Certificate Expiration Date 4/4/2028
Facility Type Other - AFH
Lab Director ALLA POLYAKOV

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This page was last updated on: 6/4/2025