38D0668653 CLIA NUMBER - KAISER PERMANENTE SKYLINE MEDICAL OFFICE LAB

Laboratory Demographics

  • CLIA Code: 38D0668653
  • Facility Name: KAISER PERMANENTE SKYLINE MEDICAL OFFICE LAB
  • Facility Address: 5125 SKYLINE RD SOUTH
    SALEM, OR
    ZIP 97306
  • Facility Phone: 503 571-9147
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JULIA BONCHER
  • NPI Number: 1992711022
  • Taxonomy: 124Q00000X - Dental Hygienist

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CLIA Record

Field Name Field Value
CLIA Number 38D0668653
LAB Type Physician Office
Facility Name KAISER PERMANENTE SKYLINE MEDICAL OFFICE LAB
Street 5125 SKYLINE RD SOUTH
City SALEM
State OR
ZIP 97306
Phone 503 571-9147
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 8/20/2025
Certificate Expiration Date 8/19/2027
Facility Type Physician Office
Lab Director JULIA BONCHER

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