50D2254117 CLIA NUMBER - POPLAR RIDGE ADULT FAMILY HOME DBA ELENA'S HOME AT LAKE RD 1

Laboratory Demographics

  • CLIA Code: 50D2254117
  • Facility Name: POPLAR RIDGE ADULT FAMILY HOME DBA ELENA'S HOME AT LAKE RD 1
  • Facility Address: 14428 LAKE RD
    LYNNWOOD, WA
    ZIP 98087
  • Facility Phone: 425 582-2543
  • Facility Type: Other - ADULT FAMILY HOME
  • Facility Type: Waiver
  • Lab Director: CARMELITA ANGELES

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CLIA Record

Field Name Field Value
CLIA Number 50D2254117
LAB Type Other - ADULT FAMILY HOME
Facility Name POPLAR RIDGE ADULT FAMILY HOME DBA ELENA'S HOME AT LAKE RD 1
Street 14428 LAKE RD
City LYNNWOOD
State WA
ZIP 98087
Phone 425 582-2543
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/28/2022
Certificate Expiration Date 4/4/2028
Facility Type Other - ADULT FAMILY HOME
Lab Director CARMELITA ANGELES

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