I wouldn't say that was unduly noisy Rob, although there is noise in the darker areas where you'd expect to see some. Overall I'd say the shot is looking a bit dark and under-exposed - under-exposure will drastically increase noise in your shots. It will always be more evident in the darker areas.
It appears that you've taken the shot directly from on camera (looking at the shadows). Due to the way flash works, the light has hit the foreground detail of the AV unit - bounced back to the camera and the onboard sensor has quenched the flash long before the far part of the unit and the background has received adequate light from the flash.
Try bouncing the flash from the ceiling or from somewhere on the right to give a more evenly diffused flash and better spread of light. Metering for the ambient room light and using flash as a fill (slow speed sync) will probably give the most natural looking result.
Use the lowest ISO you can and avoid under exposure for lowest noise in your shots.