38D0622248 CLIA NUMBER - PEDIATRIC PRACTICES ADMINISTRATION, LLC

Laboratory Demographics

  • CLIA Code: 38D0622248
  • Facility Name: PEDIATRIC PRACTICES ADMINISTRATION, LLC
  • Facility Address: 14279 S GLEN OAK RD
    OREGON CITY, OR
    ZIP 97045
  • Facility Phone: 503 657-7629
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KRISTINE BUGAKOV
  • NPI Number: 1588163844
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 38D0622248
LAB Type Physician Office
Facility Name PEDIATRIC PRACTICES ADMINISTRATION, LLC
Street 14279 S GLEN OAK RD
City OREGON CITY
State OR
ZIP 97045
Phone 503 657-7629
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/1/2024
Certificate Expiration Date 12/31/2025
Facility Type Physician Office
Lab Director KRISTINE BUGAKOV

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