50D2273533 CLIA NUMBER - MOUNTLAKE TERRACE AFH

Laboratory Demographics

  • CLIA Code: 50D2273533
  • Facility Name: MOUNTLAKE TERRACE AFH
  • Facility Address: 22903 57TH AVE W
    MOUNTLAKE TERRACE, WA
    ZIP 98043
  • Facility Phone: 425 775-6913
  • Facility Type: Other - AFH
  • Facility Type: Waiver
  • Lab Director: RAMONA MARICUTU
  • NPI Number: 1164042040
  • Taxonomy: 1223G0001X - Dentist

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 50D2273533
LAB Type Other - AFH
Facility Name MOUNTLAKE TERRACE AFH
Street 22903 57TH AVE W
City MOUNTLAKE TERRACE
State WA
ZIP 98043
Phone 425 775-6913
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/14/2022
Certificate Expiration Date 4/4/2028
Facility Type Other - AFH
Lab Director RAMONA MARICUTU

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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