50D2293280 CLIA NUMBER - PRISTINE HOUSE RENTON LLC

Laboratory Demographics

  • CLIA Code: 50D2293280
  • Facility Name: PRISTINE HOUSE RENTON LLC
  • Facility Address: 15207 SE 178TH PL
    RENTON, WA
    ZIP 98058
  • Facility Phone: 425 282-4501
  • Facility Type: Other - AFH
  • Facility Type: Waiver
  • Lab Director: ANITA KHADKA
  • NPI Number: 1447027883
  • Taxonomy: 163W00000X - Registered Nurse

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CLIA Record

Field Name Field Value
CLIA Number 50D2293280
LAB Type Other - AFH
Facility Name PRISTINE HOUSE RENTON LLC
Street 15207 SE 178TH PL
City RENTON
State WA
ZIP 98058
Phone 425 282-4501
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/6/2023
Certificate Expiration Date 4/4/2028
Facility Type Other - AFH
Lab Director ANITA KHADKA

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