38D0713192 CLIA NUMBER - COLUMBIA MEDICAL CLINIC PC

Laboratory Demographics

CLIA Number: 38D0713192

Facility Name: COLUMBIA MEDICAL CLINIC PC

Facility Address:
9735 SW SHADY LN SUITE 100
TIGARD, OR
ZIP 97223
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Facility Phone Number: 503 639-2800

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1730106717

Taxonomy: 305R00000X - Preferred Provider Organization
A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level.

CLIA Record

Field Name	Field Value
CLIA Number	38D0713192
LAB Type	Physician Office
Facility Name	COLUMBIA MEDICAL CLINIC PC
Street	9735 SW SHADY LN SUITE 100
City	TIGARD
State	OR
ZIP	97223
Phone	503 639-2800
CertificateType	3
CertificateEffectiveDate	6/26/2023
CertificateExpirationDate	6/25/2025
FacilityType	PPMP

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This page was last updated on: 4/23/2024