50D2313760 CLIA NUMBER - EVERGREEN GARDENS LL

Laboratory Demographics

  • CLIA Code: 50D2313760
  • Facility Name: EVERGREEN GARDENS LL
  • Facility Address: 1901 SHATTUCK AVE S
    RENTON, WA
    ZIP 98055
  • Facility Phone: 425 572-5823
  • Facility Type: Other - AFH
  • Facility Type: Waiver
  • Lab Director: PETER GUNTER
  • NPI Number: 1013965722
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 50D2313760
LAB Type Other - AFH
Facility Name EVERGREEN GARDENS LL
Street 1901 SHATTUCK AVE S
City RENTON
State WA
ZIP 98055
Phone 425 572-5823
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/6/2024
Certificate Expiration Date 4/4/2028
Facility Type Other - AFH
Lab Director PETER GUNTER

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