38D0703054 CLIA NUMBER - CHILDREN'S COMMUNITY CLINIC

Laboratory Demographics

  • CLIA Code: 38D0703054
  • Facility Name: CHILDREN'S COMMUNITY CLINIC
  • Facility Address: 2252 LLOYD CENTER
    PORTLAND, OR
    ZIP 97232
  • Facility Phone: 503 284-5239
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: MS. MARDICA HICKS
  • NPI Number: 1841483252
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 38D0703054
LAB Type Community Clinic
Facility Name CHILDREN'S COMMUNITY CLINIC
Street 2252 LLOYD CENTER
City PORTLAND
State OR
ZIP 97232
Phone 503 284-5239
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 Community Clinic
Lab Director MS. MARDICA HICKS

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