38D0691177 CLIA NUMBER - GLISAN POST ACUTE

Laboratory Demographics

  • CLIA Code: 38D0691177
  • Facility Name: GLISAN POST ACUTE
  • Facility Address: 9750 NE GLISAN STREET
    PORTLAND, OR
    ZIP 97220
  • Facility Phone: 503 256-3920
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DAVID LARSON
  • NPI Number: 1992791214
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 38D0691177
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name GLISAN POST ACUTE
Street 9750 NE GLISAN STREET
City PORTLAND
State OR
ZIP 97220
Phone 503 256-3920
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 Skilled Nursing Facility/Nursing Facility
Lab Director DAVID LARSON

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