38D0966985 CLIA NUMBER - CALCAGNO PEDIATRICS

Laboratory Demographics

  • CLIA Code: 38D0966985
  • Facility Name: CALCAGNO PEDIATRICS
  • Facility Address: 23331 SE STARK ST STE 201
    GRESHAM, OR
    ZIP 97030
  • Facility Phone: 503 491-0714
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: YESENIA J. AMBRIZ
  • NPI Number: 1255322194
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 38D0966985
LAB Type Physician Office
Facility Name CALCAGNO PEDIATRICS
Street 23331 SE STARK ST STE 201
City GRESHAM
State OR
ZIP 97030
Phone 503 491-0714
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/16/2025
Certificate Expiration Date 2/15/2027
Facility Type Physician Office
Lab Director YESENIA J. AMBRIZ

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