50D2265211 CLIA NUMBER - PACIFIC COUNTRY HOMES 2

Laboratory Demographics

  • CLIA Code: 50D2265211
  • Facility Name: PACIFIC COUNTRY HOMES 2
  • Facility Address: 3215 PACIFIC WAY
    LONGVIEW, WA
    ZIP 98632
  • Facility Phone: 360 578-1918
  • Facility Type: Other - AFH
  • Facility Type: Waiver
  • Lab Director: ANNALIZA ESTACIO
  • NPI Number: 1558841361
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 50D2265211
LAB Type Other - AFH
Facility Name PACIFIC COUNTRY HOMES 2
Street 3215 PACIFIC WAY
City LONGVIEW
State WA
ZIP 98632
Phone 360 578-1918
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/25/2022
Certificate Expiration Date 4/4/2028
Facility Type Other - AFH
Lab Director ANNALIZA ESTACIO

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