50D2272375 CLIA NUMBER - PRESTIGE SENIOR LIVING BRIDGEWOOD

Laboratory Demographics

  • CLIA Code: 50D2272375
  • Facility Name: PRESTIGE SENIOR LIVING BRIDGEWOOD
  • Facility Address: 11700 NE ANGELO DR
    VANCOUVER, WA
    ZIP 98684
  • Facility Phone: 360 254-4666
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: CHANTHY ROBINSON
  • NPI Number: 1588063242
  • Taxonomy: 225100000X - Physical Therapist

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CLIA Record

Field Name Field Value
CLIA Number 50D2272375
LAB Type Assisted Living Facility
Facility Name PRESTIGE SENIOR LIVING BRIDGEWOOD
Street 11700 NE ANGELO DR
City VANCOUVER
State WA
ZIP 98684
Phone 360 254-4666
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/18/2022
Certificate Expiration Date 4/4/2028
Facility Type Assisted Living Facility
Lab Director CHANTHY ROBINSON

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