50D1090699 CLIA NUMBER - MIRABELLA

Laboratory Demographics

  • CLIA Code: 50D1090699
  • Facility Name: MIRABELLA
  • Facility Address: 116 FAIRVIEW AVE
    SEATTLE, WA
    ZIP 98109
  • Facility Phone: (206) 254-1452
  • Facility Type: Intermediate Care Facility for Mentally Retarded
  • Facility Type: Waiver
  • Lab Director: MAX KUHLMAN
  • NPI Number: 1679722805
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 50D1090699
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name MIRABELLA
Street 116 FAIRVIEW AVE
City SEATTLE
State WA
ZIP 98109
Phone 2062541452
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/16/2008
Certificate Expiration Date 4/4/2028
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director MAX KUHLMAN

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This page was last updated on: 5/18/2026