38D0954415 CLIA NUMBER - EPIPHANY DERMATOLOGY OF OREGON, LLC

Laboratory Demographics

  • CLIA Code: 38D0954415
  • Facility Name: EPIPHANY DERMATOLOGY OF OREGON, LLC
  • Facility Address: 2222 NW LOVEJOY, SUITE 422
    PORTLAND, OR
    ZIP 97210
  • Facility Phone: 503 227-7117
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: PATRICIA L. NORRIS
  • NPI Number: 1306873203
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 38D0954415
LAB Type Physician Office
Facility Name EPIPHANY DERMATOLOGY OF OREGON, LLC
Street 2222 NW LOVEJOY, SUITE 422
City PORTLAND
State OR
ZIP 97210
Phone 503 227-7117
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 9/9/2024
Certificate Expiration Date 9/8/2026
Facility Type Physician Office
Lab Director PATRICIA L. NORRIS

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