50D2277173 CLIA NUMBER - VINE MAPLE CARE HOME LLC

Laboratory Demographics

  • CLIA Code: 50D2277173
  • Facility Name: VINE MAPLE CARE HOME LLC
  • Facility Address: 12530 VINE MAPLE DR SW
    LAKEWOOD, WA
    ZIP 98499
  • Facility Phone: 253 301-0099
  • Facility Type: Other - AFH
  • Facility Type: Waiver
  • Lab Director: LUZVIMINDA MONAGHAN
  • NPI Number: 1154891224
  • Taxonomy: 311ZA0620X - Custodial Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 50D2277173
LAB Type Other - AFH
Facility Name VINE MAPLE CARE HOME LLC
Street 12530 VINE MAPLE DR SW
City LAKEWOOD
State WA
ZIP 98499
Phone 253 301-0099
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/3/2024
Certificate Expiration Date 4/4/2028
Facility Type Other - AFH
Lab Director LUZVIMINDA MONAGHAN

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