50D2313033 CLIA NUMBER - AVENUE HOME LLC

Laboratory Demographics

  • CLIA Code: 50D2313033
  • Facility Name: AVENUE HOME LLC
  • Facility Address: 719 23RD AVE SE
    PUYALLUP, WA
    ZIP 98372
  • Facility Phone: 253 348-6004
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: ESTHER N. MACHARIA
  • NPI Number: 1225894165
  • Taxonomy: 311ZA0620X - Custodial Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 50D2313033
LAB Type Assisted Living Facility
Facility Name AVENUE HOME LLC
Street 719 23RD AVE SE
City PUYALLUP
State WA
ZIP 98372
Phone 253 348-6004
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/23/2024
Certificate Expiration Date 4/4/2028
Facility Type Assisted Living Facility
Lab Director ESTHER N. MACHARIA

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