38D0621790 CLIA NUMBER - BEVERLY DE LA BRUERE MD LAB

Laboratory Demographics

  • CLIA Code: 38D0621790
  • Facility Name: BEVERLY DE LA BRUERE MD LAB
  • Facility Address: 18151 SE HWY 212
    DAMASCUS, OR
    ZIP 97089
  • Facility Phone: 503 658-6022
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: BEVERLY A. DE LA BRUERE MD
  • NPI Number: 1720176332
  • Taxonomy: 207QA0401X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 38D0621790
LAB Type Physician Office
Facility Name BEVERLY DE LA BRUERE MD LAB
Street 18151 SE HWY 212
City DAMASCUS
State OR
ZIP 97089
Phone 503 658-6022
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 1/1/2024
Certificate Expiration Date 12/31/2025
Facility Type Physician Office
Lab Director BEVERLY A. DE LA BRUERE MD

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