50D2304578 CLIA NUMBER - EVERGREEN ADULT FAMILY HOME

Laboratory Demographics

  • CLIA Code: 50D2304578
  • Facility Name: EVERGREEN ADULT FAMILY HOME
  • Facility Address: 9113 9TH AVE SE
    EVERETT, WA
    ZIP 98208
  • Facility Phone: 425 512-9965
  • Facility Type: Other - AFH
  • Facility Type: Waiver
  • Lab Director: YITAGESSU BEKELE
  • NPI Number: 1932224672
  • Taxonomy: 103TC0700X - Psychologist

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CLIA Record

Field Name Field Value
CLIA Number 50D2304578
LAB Type Other - AFH
Facility Name EVERGREEN ADULT FAMILY HOME
Street 9113 9TH AVE SE
City EVERETT
State WA
ZIP 98208
Phone 425 512-9965
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/15/2024
Certificate Expiration Date 4/4/2028
Facility Type Other - AFH
Lab Director YITAGESSU BEKELE

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