38D0662232 CLIA NUMBER - SALEM SURGERY CENTER, LLC DBA NORTHBANK SURGICAL CENTER

Laboratory Demographics

  • CLIA Code: 38D0662232
  • Facility Name: SALEM SURGERY CENTER, LLC DBA NORTHBANK SURGICAL CENTER
  • Facility Address: 2525 12TH ST SE STE 110
    SALEM, OR
    ZIP 97302
  • Facility Phone: 503 364-3704
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MELVIN D. WADE
  • NPI Number: 1619933264
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 38D0662232
LAB Type Ambulatory Surgery Center
Facility Name SALEM SURGERY CENTER, LLC DBA NORTHBANK SURGICAL CENTER
Street 2525 12TH ST SE STE 110
City SALEM
State OR
ZIP 97302
Phone 503 364-3704
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 Ambulatory Surgery Center
Lab Director MELVIN D. WADE

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