50D2316498 CLIA NUMBER - EMMANUEL ADULT FAMILLY HOME

Laboratory Demographics

  • CLIA Code: 50D2316498
  • Facility Name: EMMANUEL ADULT FAMILLY HOME
  • Facility Address: 1902 SE BELLA VISTA RD
    VANCOUVER, WA
    ZIP 98683
  • Facility Phone: 360 944-6556
  • Facility Type: Other - AFH
  • Facility Type: Waiver
  • Lab Director: ALEKSEY I. KRASOVSKIY
  • NPI Number: 1316936164
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 50D2316498
LAB Type Other - AFH
Facility Name EMMANUEL ADULT FAMILLY HOME
Street 1902 SE BELLA VISTA RD
City VANCOUVER
State WA
ZIP 98683
Phone 360 944-6556
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/7/2025
Certificate Expiration Date 4/4/2028
Facility Type Other - AFH
Lab Director ALEKSEY I. KRASOVSKIY

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