38D0972447 CLIA NUMBER - DIALYSIS CENTERS OF OREGON LLC DBA US RENAL CARE GRESHAM DIALYSIS

Laboratory Demographics

CLIA Number: 38D0972447

Facility Name: DIALYSIS CENTERS OF OREGON LLC DBA US RENAL CARE GRESHAM DIALYSIS

Facility Address:
1360 E POWELL BLVD
GRESHAM, OR
ZIP 97030
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Facility Phone Number: 503 465-1650

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1093786105

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	38D0972447
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	DIALYSIS CENTERS OF OREGON LLC DBA US RENAL CARE GRESHAM DIALYSIS
Street	1360 E POWELL BLVD
City	GRESHAM
State	OR
ZIP	97030
Phone	503 465-1650
CertificateType	4
CertificateEffectiveDate	4/7/2024
CertificateExpirationDate	4/6/2026
FacilityType	Waiver

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