38D0978577 CLIA NUMBER - WILLAMETTE MEDICAL LABORATORIE

Laboratory Demographics

  • CLIA Code: 38D0978577
  • Facility Name: WILLAMETTE MEDICAL LABORATORIE
  • Facility Address: 4800 MEADOWS RD #100
    LAKE OSWEGO, OR
    ZIP 97035
  • Facility Phone: 503 907-9605
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JERRY DARM
  • NPI Number: 1891025854
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 38D0978577
LAB Type Physician Office
Facility Name WILLAMETTE MEDICAL LABORATORIE
Street 4800 MEADOWS RD #100
City LAKE OSWEGO
State OR
ZIP 97035
Phone 503 907-9605
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/27/2024
Certificate Expiration Date 9/26/2026
Facility Type Physician Office
Lab Director JERRY DARM

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