50D2262436 CLIA NUMBER - VICTORIA 1 ADULT FAMILY HOME

Laboratory Demographics

CLIA Number: 50D2262436

Facility Name: VICTORIA 1 ADULT FAMILY HOME

Facility Address:
13321 31ST AVE NE
SEATTLE, WA
ZIP 98125
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Facility Phone Number: 425 503-3808

Facility Type: Other - AFH

Certificate Type: Waiver

NPI Number: 1326321001

Taxonomy: 183500000X - Pharmacist
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

CLIA Record

Field Name	Field Value
CLIA Number	50D2262436
LAB Type	Other - AFH
Facility Name	VICTORIA 1 ADULT FAMILY HOME
Street	13321 31ST AVE NE
City	SEATTLE
State	WA
ZIP	98125
Phone	425 503-3808
CertificateType	4
CertificateEffectiveDate	6/14/2022
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

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This page was last updated on: 4/23/2024