50D2315911 CLIA NUMBER - WHITE OAK VILLAGE MEMORY CARE COMMUNITY

Laboratory Demographics

  • CLIA Code: 50D2315911
  • Facility Name: WHITE OAK VILLAGE MEMORY CARE COMMUNITY
  • Facility Address: 14715 NE 20TH AVE
    VANCOUVER, WA
    ZIP 98686
  • Facility Phone: 503 399-9999
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: DOUGLAS SPROUL
  • NPI Number: 1356147334
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 50D2315911
LAB Type Assisted Living Facility
Facility Name WHITE OAK VILLAGE MEMORY CARE COMMUNITY
Street 14715 NE 20TH AVE
City VANCOUVER
State WA
ZIP 98686
Phone 503 399-9999
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/20/2024
Certificate Expiration Date 4/4/2028
Facility Type Assisted Living Facility
Lab Director DOUGLAS SPROUL

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