50D2292950 CLIA NUMBER - EVERGREEN PARK AT GREEN LAKE

Laboratory Demographics

  • CLIA Code: 50D2292950
  • Facility Name: EVERGREEN PARK AT GREEN LAKE
  • Facility Address: 7520 E GREEN LAKE DR N
    SEATTLE, WA
    ZIP 98103
  • Facility Phone: 206 985-2048
  • Facility Type: Other - AFH
  • Facility Type: Waiver
  • Lab Director: MADLAZI RUFARO
  • NPI Number: 1912794819
  • Taxonomy: 311ZA0620X - Custodial Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 50D2292950
LAB Type Other - AFH
Facility Name EVERGREEN PARK AT GREEN LAKE
Street 7520 E GREEN LAKE DR N
City SEATTLE
State WA
ZIP 98103
Phone 206 985-2048
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/1/2023
Certificate Expiration Date 4/4/2028
Facility Type Other - AFH
Lab Director MADLAZI RUFARO

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