50D2317769 CLIA NUMBER - SOUTH HILL AFH LLC II

Laboratory Demographics

  • CLIA Code: 50D2317769
  • Facility Name: SOUTH HILL AFH LLC II
  • Facility Address: 12121 130TH AVENUE CT E
    PUYALLUP, WA
    ZIP 98374
  • Facility Phone: 732 527-2266
  • Facility Type: Other - AFH
  • Facility Type: Waiver
  • Lab Director: ELIZABETH MWANGI
  • NPI Number: 1821159047
  • Taxonomy: 1223P0221X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 50D2317769
LAB Type Other - AFH
Facility Name SOUTH HILL AFH LLC II
Street 12121 130TH AVENUE CT E
City PUYALLUP
State WA
ZIP 98374
Phone 732 527-2266
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/30/2025
Certificate Expiration Date 4/4/2028
Facility Type Other - AFH
Lab Director ELIZABETH MWANGI

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