CLIA lab
CLIA 50D2169168: Brookdale Montclair Poulsbo
Poulsbo, WA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 50D2169168 belongs to Brookdale Montclair Poulsbo in Poulsbo, WA.
Certificate of Waiver, effective July 16, 2019, expires April 4, 2028.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- July 16, 2019
- Certificate expiration
- April 4, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- July 16, 2019
- Facility type
- Assisted living facility
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA exempt laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 50D2169168
- Lab name
- Brookdale Montclair Poulsbo
- Address
- 1250 NE Lincoln Rd, Poulsbo, WA 98370
- Phone
- (360) 697-2223
- Fax
- (360) 598-9517
Annual test volume the lab reported
- Waived tests
- 1,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Frontier DermatologyCertificate of Compliance, Physician office50D2108446
- Kinwell HealthCertificate of Waiver, Physician office50D2267099
- Kitsap Obgyn PLLCCertificate for Provider-Performed Microscopy Procedures, Physician office50D0909341
- Liberty Shores Assisted LivingCertificate of Waiver, Assisted living facility50D2078840
- Martha and Mary Health ServicesCertificate of Waiver, Skilled nursing or nursing facility50D0635392
- North Kitsap Ambulatory Surgery CenterCertificate of Waiver, Ambulatory surgery center50D0635394
- North Kitsap School DistrictCertificate of Waiver, School or student health service50D2241279
- Pacific EyecareCertificate of Waiver, Physician office50D2136630
Related
Questions
What is the CLIA number for Brookdale Montclair Poulsbo in Poulsbo?
50D2169168, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Brookdale Montclair Poulsbo hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 50D2169168 expire?
The CMS file lists April 4, 2028 as the certificate expiration date; the certificate took effect July 16, 2019.